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FIFTH BIENNIAL REPORT
OP THE
NORTH CAROLINA
BOARD OF HEALTH,
1893-1894.
Cfte Library
of tipe
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FIFTH BIENNIAL REPORT
t
OF THE
NORTH CAROLINA
BOARD or HEALTH,
1893-1894.
RALEIGH:
JosEPHus Daniels, State Printer and Binder.
PRESSES OF E. M. UZZELL.
1895.
2.^970-
MEMBERS OF THE BOARD
ELECTED BY THE MEDICAL SOCIETY OF THE STATE OF
NORTH CAROLINA.
George GillETT Thomas, M. D., President: Wilniiugtou.
Term Expires iSgy.
S. Westray Battle, M. D Asheville.
Term Expires 1897.
W. H. Harrele, M. D Williamstou.
Term Expires 1S95.
John Whitehead, M. D Salisbury.
Term EJxpires 1S95.
APPOINTED BY THE GOVERNOR.
W. H. G. Lucas, M. D White Hall.
Term Expires 1895.
W. P. Beael, M. D Greensboro.
Term Expires 1S95.
F. P. Venable, Ph. D., F. C. S Chapel Hill.
Term Expires 1S95.
John C. Chase, Sauitar}' Engineer Wilmington.
Terni Expires 1895.
Richard H. Lewis, M. D., Secretary Raleigh.
Term Expires 1895.
STANDING COMMITTEES.
Epidemics—Drs. Lewis and Whitehead.
Water Supply and Drainage—Dr. Thomas and Mr. Chase.
Hygienics of Public Schools—Drs. Whitehead and Lucas.
Climatology—Dr. S. W.' Battle.
Adulteration of Food and Medicines—Prof. F. P. Venable.
Sanitary Condition of State Institutions—Drs. Harrell and Beall.
Vital Statistics—Drs. Lewis, Thomas and Harrell.
LIST OF COUNTY SUPERINTENDENTS OF HEALTH IN THE
STATE OF NORTH CAROLINA, DECEMBER 31, 1894.
Alamance—Dr. R. A. Freeniau, Burliugton.
Alexander—Dr. R. B. Killiau, Taylorsville.
Alleghany—Dr. C. G. Fowlkes, Topia.
Anson—Dr. E. S. Ashe, Wadesboro.
Ashe—Dr. L. C. Gentr}-, Jefferson.
Be.aUFORT—Dr. John C. Rodman, Washington.
Bertie—Dr. H. V. Dunstau, Windsor.
Bladen—Dr. Newton RoVjinson, Elizabethtown.
Brunswick—Dr. D. I. Watson, Southport.
Buncombe—Dr. H. L. Baird, Asheville.
Burke—Dr. J. L. Laxton, Morgantou.
Cabarrus—Dr. Leona M. Archey, Concord.
Caldwell—Dr. A. A. Kent, Lenoir.
Camden—
Carteret—Dr. George N. Ennett, Beaufort.
Caswell—Dr. W. O. Spencer, Yanceyville.
Catawba—Dr. J. M. McCorkle, Newton.
Ch.atham—Dr. L. A. Hanks, Pittsboro.
Cherokee—Dr. J. F. Abemathy, Rlurphy.
Chowan—Dr. R. A. Winborne, Barnitz.
Clay—Dr. W. E. Sanderson, Hayesville.
Cleveland—Dr. O. P. Gardner, Shelby.
Columbus—Dr. I. Jackson, Wliiteville.
Craven—Dr. Leinster Duffy, Newliern.
Cumberland—Dr. J. H. Marsh, Fayetteville.
Currituck—
Dare—Dr. W. H. Peterson, Mauteo.
Davidson—Dr. R. L. Payne, Jr., Lexington.
Davie—Dr. James McGuire, Mocksville.
Duplin—Dr. W. P. Kennedy, W'arsaw.
Durham—Dr. John M. Manning, Durham.
Edgecombe—Dr. Donald Williams, Tarboro.
Forsyth—Dr. D. N. Dalton, Winston.
Franklin—Dr. E. S. Foster, Louisburg.
Gaston—Dr. J. H. Jenkins, Dallas.
Gates—Dr. I W. Costen, Gatesville.
Graham—
Granville—Dr. W. O. Baskerville, Oxford.
Greene—Dr. E. H. Sugg, Snow Hill.
Guilford—Dr. A. R. Wilson, Greensboro.
4 LIST OF SUPERINTENDENTS OF HEALTH.
Halifax—Dr. I. E. Greeu, Weldoii.
Harnett—Dr. J. F. McKay, Dickiusou.
Haywood—Dr. J. Howell Way, Waynesville.
Henderson-Dr. J. L. Egertou, Heudersouville.
Hertford—Dr. John W. Tayloe, Union.
Hyde-
Iredell—Dr. W. J. Hill, Statesville.
Jackson—Dr. W. F. Tompkins, Webster.
Johnston—Dr. R. J. Noble, Selma.
Jones—Dr. R. A. Whitaker, Trenton.
Lenoir—Dr. C. B. Woodley, Kioston.
Lincoln—Dr. W. L. Crouse, Lincolnton.
Macon—Dr. S. H. Lyle, Franklin.
Madison—Dr. James K. Hardwicke, Marshall.
Martin—Dr. W. H. Harrell, Williamston.
McDowell—Dr. B. A. Cheek, Marion.
Mecklenburg—Dr. H. INI. Wilder, Charlotte.
Mitchell—Dr C. E. vSmith, Bakersville.
Montgomery—Dr. W. A. Simmons, Troy.
Moore—Dr. Gilbert McLeod, Carthage.
Nash—Dr. J. J. Mann, Nashville.
New Hanover—Dr. R. D. Jewett, Wilmington.
Northampton—Dr. H. W. Lewis, Jackson.
Onslow—Dr. E. L. Cox, Jacksonville.
Orange—Dr. C. D. Jones, Hillsboro.
Pamlico—
Pasquotank—Dr. W. W. Griggs, Elizabeth City.
Pender—Dr. George F. Lucas, Carrie.
Perquimans-Dr. John F. Speight, Hertford.
Person—Dr. C. G. Nichols, Roxboro.
Pitt—Dr. W. H. Bagwell, Greenville.
Polk—Dr. O. S. Missildine, Tryon.
Randolph—Dr. J. M. Boyette, Ashboro.
Richmond—Dr. J. M. Covington, Rockingham.
Robeson—Dr. T. A. Norment, Jr., Lumbertou.
Rockingham—Dr. D. W. Courts, Reidsville.
Rowan—Dr. John Whitehead, Salisbury.
Rutherford—Dr. W. A. Thompson, Rutherfordton.
Sampson—Dr. John A. Stevens, Clinton.
Stanly—Dr. D. P. Whitley, Millingport.
Stokes—Dr. W. L. McCanless, Danbury.
Surry—Dr. J. B. Hollingsworth, :Mt. Airy.
Swain—Dr. R. L. Davis, Bryson City.
Transylvania—Dr. C. W. Hunt, Brevard.
LIST OF SUPERINTENDENTS OF HEALTH. 5
TyrreI/L—Dr. Ab. Alexander, Columbia.
Union—Dr. J. K. Ashcraft, Monroe.
V.\NCE— Dr. W. T. Cheatham, Henderson.
Wake—Dr. P. E. Hiues, Raleigh.
Warren—Dr. P. J. Macon, Warrenton.
Washington—
Watauga—Dr. W. B. Councill, Boone.
Wayne—Dr. W. J. Jones, Jr., Goldsboro.
Wilkes—Dr. J. W. White, Wilkesl)oro.
Wilson—Dr. Albert Anderson, Wilson.
Yadkin—Dr. T. R. Harding, Yadkiiiville.
Yancey—Dr. J. L. Ra3-, Bnrnsville.
LETTER OF TRANSMISSION.
North Carolina Board of Health,
Office of the Secretary,
Raleigh, N. C, January 4, 1895.
His Excellency^ Elias Carr,
Governor of North Carolina^
Sir:—In accordance with Section 3, Chapter 214, Laws
of 1893, I have the honor to present this the Fifth Biennial
Report of the North Carolina Board of Health.
With great respect,
Yonr obedient servant,
RICHARD H. LEWIS, M. D.,
Secretary and Treasurer.
FIFTH BIE:NNIAL REPORT
OP THE
NORTH CAROLINA BOARD OF HEALTH.
1893=1894.
lu the two years that have elapsed since our last re[)ort
the cause of public hygiene iii our State has been markedly ,
advanced. The interest in this most important subject,
both on the part of members of the medical profession and
of the people generally, shows a very decided increase.
While our work has been, and continues to be, largely
"missionary" in character—to carry to those ignorant of,
or indifferent to, its saving power the gospel of health
—
the Board has accomplished much positive good. We feel
that we can claim without hesitation that the saving of
many valuable lives and the prevention of a large amount
of sickness can be directly traced to its efforts. The pro-visions
of the law enacted by the last General Assembly
requiring physicians to report immediately to the proper
health officer cases of contagious and infectious disease and
making it obligatory upon said health officer to see that
such diseases "are properly quarantined and isolated within
twenty-four hours after the case is brought to his knowl-edge,
and that after the death or recovery or removal of a
person sick of either of the diseases mentioned the rooms
occupied and the articles used by the patient are thoroughly
disinfected in the manner set forth in the printed instruc-tions,
both as to quarantine and disinfection, which shall
be furnished him by the Secretar}^ of the State Board of
8 NORTH CAROLINA BOARD OF HEALTH.
Health," have alone saved a loss to the State in dollars and
cents, considering death and sickness in terms of money,
far more than has been expended upon the Board from its
establishment. Unfortunately the evidence in support of
sanitarv science is necessarilv nee:ative in character. Its
function is not to cure disease and thus to positively save
from death, Ijut to prevent the inauguration of disease in
the first instance and thus to save the well from both sick-ness
and death which in many instances would have surely
come to them but for the effective precautions of the health
officer. There are many other excellent features in the
new law bearing upon the protection of school children
from disease, upon the drinking waters of the State, regu-lating
common carriers, and others, for a consideration of
which we would refer the reader to the law itself which he
will find in another part of this report.
As a result of the marvelous advance in bacteriology a
great discovery has been made in "antitoxine," which is
regarded as a sure preventive of, and when used soon
enough almost a sure cure for, diphtheria, the very name
of which strikes terror to a parent's heart. The infec-tiousness
of consumption is no longer disputed and know-ing
the cause, it can often be prevented by resorting to
suitable precautions. With more knowledge we hope to do
better work, and in the next two 3^ears to save very many
more than ever before in the same length of time from
sickness and death.
MEETINGS OF THE BOARD.
MINUTES OF THE ANNUAL MEETING AT
RALEIGH IN 1893.
Raleigh, N. C, May 10, 1893.
The North CaroUiia Board of Health met iii regular
annual session in the private office of the Yarborough
House at 6 p. m.
In the temporary absence of the President Dr. George
G. Thomas vras, on motion, called to the chair. Present
:
Drs. Bahnson, Harrell, Hodges, Thomas, Veuable, Mr.
Chase and the Secretary.
On motion of Dr. Venable the action taken by the Board
in the matter of the Quarantine Station at Southport by
letter was ratified.
Dr. Bahnson, for the committee appointed to visit the
School for the Deaf and Dumb at Morganton, and advise
the Board of Directors of the same as to a water supply
and system of sewerage, submitted a report of its work,
stating that a copy had been sent to Dr. M. L. Reid, Chair-man
of the Board of Directors. On motion the report was
accepted and indorsed.
A motion to proceed to the election of officers was car-ried,
but as some doubt was expressed as to the tenure of
office of the Secretary, whether he should hold for the un-expired
term to which he was elected under the old law
('85), or whether he should be elected every two years,
since the term of office of each member of the Board was
made b}'' the new law ('93) only two years, the President
was rec|uested to obtain the opinion of the Attorney Gen-eral
and report to the meeting next morning, to which
time the Board then adjourned.
RICH'D H. LEWIS,
Secretary.
10 NORTH CAROLINA BOARD OF HEALTH.
Raleigh, X. C, May 11, 1893.
The Board re-assembled in the Senate Chamber of the
Capitol at 10 a. .m., President Bahnson in the chair.
The President stated that he had consulted the Attorney
General as to the term of office of the Secretary and that
the latter had given it as his opinion that if the Secretary
continued a member of the Board by re-appointment for so
long a time he was entitled under the Constitution of the
State to hold the office for the remainder of the six-year
term of the late Secretar}^, Dr. Thomas F. Wood, to which
he was elected.
Dr. tienry T. Bahnson was nominated for President and
unanimously re-elected.
Messrs. Chase and Venable were appointed a committee
to audit the accounts of the Treasurer. They reported
them to be correct.
Adjourned.
RICH'D H. LEWIS,
Secretary.
FIFTH BIENNIAL REPOHT. 11
ACTION OF THE NORTH CAROLINA BOARD OF
HEALTH, IN jREGARD TO THE RESIGNATION
OF DR. J. A. HODGES AND THE ELECTION OF
HIS SUCCESSOR.
The following letter, which ex})lains itself, was sent to
every member of the Board
:
North Carolixa Board of Health,
Secretary's Office,
Raleigh, November 6, 1893.
My dear Doctor :—I am instructed by President Bahnson to notify
the members of the Board of the resignation, upon his removal from
the State, of Dr. J. A. Hodges, and to ask eacli member to indicate in a
letter to the Secretary (in order to save tlie expense of a meeting for the
purpose) what action he desires taken thereon, and his choice for his
successor.
Please write me promptly in accordance with the above and oblige,
Yours truly,
EICH'D H. LEWIS,
Secretary.
By the answers to the above letter received from all the
members of the Board, and now on file in the Secretary's
office, the resignation of Dr. Hodges was accepted and Dr.
John Whitehead, of Salisbury, was unanimously elected to
fill the vacancy.
Dr. Whitehead was duly notified of his election and
signified his acceptance of the position.
RICH'D H. LEWIS,
Secretary.
12 NOKTH CAROLINA BOARD OF HEALTH.
MINUTES OF THE ANNUAL MEETING AT
GREENSBORO IN 1894.
Greensboro, N. C, May 15, 1894.
TJie North Carolina Board of Health met in regular
annual session in Room 15, Benbow House, at 9 p. m.
There were present Drs. Bahnson, President; Harrell,
Whitehead and Venable, Mr. Chase and the Secretary.
• The minutes of the last meeting and of the action of
the Board in regard to the resignation of Dr. J. A. Hodges
and the election of his successor were read and approved.
Messrs. Chase and Venable were appointed by the Presi-dent
a committee to audit the accounts of the Treasurer.
The matter of the erection of a first-class Quarantine
Station at Southport was informally discussed. Great regret
was expressed at the action of the authorities of the city
of Wilmington in refusing to appropriate the $5,000 neces-sary
as a preliminary condition to receiving $20,000 from
the State.
The transmission of typhoid fever was the subject of a
general discussion of a very interesting character.
On motion it was ordered that the Board meet hereafter
three times a year—every four mouths—the annual meet-ing
to be held as usual with the State Medical Society, and
the other two in September and January at such place as
the Board may select and on such day as the President
may appoint.
On motion Salisbury was selected as the place for the
next or September meeting. The President was requested
to appoint the day at his convenience.
On motion it was ordered that the public institutions of
the State, including the convict camps, be inspected as far
as practicable during the current year.
FIFTH BIENNIAL REPORT. 13
On motion the Secretary was instructed to i)urchase a
library of reference books on sanitary subjects for the use
of his office, and also similar books for the use of members
of the Board.
Adjourned to 12 o'clock to-morrow.
RICH'D H. LEWIS,
Secretary.
Greensboro, N. C, May 1<3, 1894.
The Board re-assembled in Room 15 of the Benbow
House at 6:40 p. m.: President Bahnson in the chair.
Present: Drs. Bahnson, Battle, Harrell and Whitehead,
Mr. Chase, Passed Assistant Surgeon J. J. Kinyoun, M.
H. S., and the Secretary.
In response to an invitation from the Board to address
them, Dr. Kinyoun made the following statement:
The Surgeon General of the ]\Jarine Hospital Service,
Dr. Wyman, is very anxious to have all the larger ports
put in good shape. All the ports except Wilmington are
already well provided with quarantine facilities. It is his
earnest desire to have a perfectly equipped station at Wil-mington.
The rules under the law of February, 1893, re-quire
that the dunnage of any infected vessel must be
disinfected by steam and the hold of said vessel by 10 per
cent, sulphur. If such facilities do not exist at a port the
vessel must be remanded to a port that is supplied. This
would wreck the commerce of Wilmington as matters now
stand, which the Government would be very loth to do.
An order has been issued to captains from West Indies and
South American ports having yellow fever to report at once
to United States stations. All sailing vessels from an in-fected
port in West Indies are advised to go by one of the
national stations at Tortugas or Sapelo for inspection and
disinfection. The Surgeon General wishes to know if a
14 NORTH CAROLINA BOARD OF HEALTH.
properly equipped station cannot be established by the
State. If not the United States have the law and ample
means to do so.
After a full discussion of the above statement from the
Marine Hospital Service the following motion was intro-duced
by Dr. Battle and unanimously adopted
:
Moved, that in view of the inability or the unwillingness of the city
of Wilmington to contribute its part towards carrying out the act of the
last General Assembly providing for the erection of a first-class Quaran-tine
Station at Southport, the Secretary of this Board be instructed to
officially request the United States Marine Hospital Service to take charge
of and operate that station; and that the Secretary be authorized to
explain this action on the part of the Board.
The Auditing- Committee reported that they had exam-ined
the accounts of the Treasurer and found them correct.
Report adopted.
On motion the Board adjourned to meet in Salisbury in
Se^^tember.
RICH'D H. LEWIS,
Secretary.
MINUTES OF THE MEETING AT SALISBURY,
SEPTEMBER 13, 1894.
Salisbury, N. C, September 23, 1894.
The Board met after the adjournment of the Health Con-ference
in private session at the Central Hotel. Present:
Drs. Bahnsou, Battle, Thomas, Whitehead and Lewis.
Drs. Bahnson and Lewis were elected delegates to the
American Public Health Association. The appointment of
delegates to the National Conference of State Boards of
Health was left to the President. A letter from Dr. C. O.
Probst, Secretary of the National Conference of State Boards
of Health, stating that the annual dues of North Carolina
for 1892, $10, had not been paid, was read. Upon a state-
FIFTH 15IEXNIAL REPORT. 15
ment from the Treasurer of the Board that such was the
fact, due doubtless to the prolouged ilhiess of the Treasurer
at that tiuie, a motion was passed ordering it paid.
On motion the Secretary Avas ordered to have printed in
pamphlet form, and generally distributed, the article on
"The Prevention of Tuberculosis," by Dr. S. Westray Bat-tle,
and that on "Drinking Water in its Relation to Malarial
Diseases," by the Secretary, just read before the Health
Conference.
On motion Mr. J. C. Chase, the Engineer of the Board,
was requested to make a thorough inspection of the various
State institutions and of tlie water supplies and sewerage sys-tems,
present and prospective, of the more important cities
and towns of the State and to report the results of the same
to the Board.
On motion tlie meeting adjourned.
RICH'D H. LEWIS,
Secretary.
PROCEEDINGS HAD IX REGARD TO THE ELEC-TION
OF A PRESIDENT OF THE BOARD TO
SUCCEED DR. H. T. BAHNSON, RESIGNED.
Having been notified by his Excellency the Governor
of the resignation from the Board of Dr. H. T. Bahnson,
of Salem, for many j-ears its active and efficient President,
I addressed the following letters to each member of the
Board. They show the method of the election of Dr.
George Gillett Thomas, of Vvilmington, as his successor in
the presidenc}^ :
Raleigh, N. C, November 21, 1894.
My dear Doctor :—Dr. Bahnson, being a member of two boards, has
tbought it proper to resign from one of them, and has, I am sorry to
say, elected to give up ours. We are, therefore, without a President,
and tlie machinery of our law requires one. In order to save expense
and time it has occurred to me that it would be best for me to call for
16 NORTH CAROLINA BOARD OF HEALTH.
nominations by letter and then to send a list of the nominees to each
member of the Board for his ballot. If you approve this plan please
make a nomination. If not, let me have your views as to the best
course of action, and oblige,
Yours very truly,
RICH'D H. LEWIS,
Secretary,
P. S.—If a majority of the Board should nominate the same person
we will, if you approve, consider that an election. R. H. L.
Raleigh, N. C, December 8, 1894.
My dear Doctor:—The "returns" are all in, and Dr. G. G. Thomas
has been nominated by six (6) members and Dr. S. W. Battle by two (2)
members for President of the Board. According to the understanding
had in my former letter—that if any one member should happen to be
nominated by a majority of the Board we would, without further corre-spondence,
consider him elected—I now announce the election of Dr
George Gillett Thomas as President.
Very truly yours,
RICH'D H. LEWIS,
Secretary.
His ExcelleDcy the Governor appointed Dr. W. P. Beall,
of Greensboro, to fill the vacancy on the Board caused by
the resignation of Dr. Bahnson.
PROCEEDINGS
CONJOINT SESSIONS OF THE STATE BOARD OF HEALTH
WITH THE
State Medical Society in 1893 and 1894.
The Conjoint Session at Raleigh, May 11, 1893.
Dr. II. T. Bahnson was called upon to preside. He au-noLinced
the first business in order to be the reading of the
annual report of the Secretary :
ANNUAL REPORT OF THE SECRETARY OF THE
NORTH CAROLINA BOARD OF HEALTH.
By Richard H. Lewis, M. D., Raleigh, N. C.
By section 27 of the Act Relating to the Board of Health
the Secretary is required to submit his annual report at
this, the annual meeting of the Board. ITe is also required
by section 3 of the same to make biennially to the General
Assembly, through the Governor, a report of the work of
the Board. In comjdiance with the latter the fourth bien-nial
report for 1891-'92 was prepared and submitted, and
the portion of it covering the period from the last annual
meeting to January 1, 1893, is respectfully referred to as
a part of this report. [Read from the biennial report the
references to the life and work of Dr. Thomas F. Wood.]
On January 2d an invitation to meet with the State
Board of Health in a Health Conference on January 24th
18 NORTH CAROLINA BOARD OF HEALTH.
iu the city of Raleigh was mailed to the number of six
hundred and fifty to the officers of the State Government,
members of the General Assembly, Mayors of towns, County
Superintendents of Health, Chairmen of Boards of County
Commissioners, physicians and other prominent men. The
attendance was not ver}" large, but varied and of good
quality. The number of County Superintendents of Health
present (three, and one of them a member of the Legis-lature)
was discouraging, particularly in view of the fact
that one of the principal subjects for discussion named in
the invitation was their own salaries, about which much
complaint had been made. The following are the proceed-ings
of the Health Conference:
Raleigh, N. C, January 24, 1893.
On a call from the President of the State Board of
Health, Dr. H. T. Bahnson, of Salem, that body met in the
city of Raleigh on the above date, there being present Drs.
J. H. Tucker, J. A. Hodges, Geo. G. Thomas, Prof. F. P.
Amenable and the Secretary.
There were present also Superintendents of Health, prac-ticing
physicians and other citizens interested in sanitation
and the health of the State, all of whom were invited to
meet with the State Board of Health in a Health Con-ference.
In the absence of President Bahnson the Secretary called
the Conference to order, stating the object of the Confer-ence
to be a consideration of the best method to prevent
the introduction of pestilential diseases into the State, the
method of fixing the salaries of Superintendents of Health
and other matters relating to the general health of the
State.
He introduced the Mayor of the cit}^ of Raleigh, who
extended a cordial welcome to the Conference and assured
FIFTH BIENNIAL KEPOKT. 1 H*
it of his hearty support in its efforts to [)romote the welfare
of the State in the all-important matter of healtli.
The first order of business being the selection of a perma-nent
chairman, Dr. Thomas nominated Col. W. 11. S.
Burgwyn, a man who had shown himself to be actively
interested in the health matters of North Carolina. Col.
Burgw}'!! was unanimously elected Jind on assuming the
cliair expressed himself as feeling highly honored by being-invited
to preside over the meeting and gladly offered all
the assistance in his power to the Conference in improving
the safeguards against the ravages of plagues and epi-demics.
The prosperity of the country is largely dependent
upon the medical profession, and this is especially note-worthy
of the next twelve months when the country is to
undertake the stupendous task of entertaining the whole
world and, at the same time, guard her citizens from the
terrible plague which caused such destruction of life in
Europe last 3''ear and wliich is apparently only waiting for
the ap})roach of warm weather to renew its work of devas-tation
and destruction.
The Secretary presented as the first duty of the Con-ference
the amendment of the health laws of the State,
and read a co])y of a law suggested by the President, after
which he stated that a substitute for the old law had been
drawn up by himself for the consideration of the Con-ference.
It was moved and decided that the Secretarv read his
proposed substitute for the existing laws section by section
and if there be no objection raised the section be consid-ered
as approved by the Conference.
Section 1. Adopted without objection.
Sec. 2. There being some doubt as to whether the pro-posed
reading would call for the election of six new mem-bers
of the Board this year, it was corrected to make the
20 NORTH CAROLINA BOARD OF HEALTH.
fact clear that the successors of the present incumbents
were to be elected only at the expiration of the terms of
the present members; each new member being elected for
six years.
Sec. 3. The important part of this section is the duty of
the Board to inspect the public institutions of the State,
and the Secretary explained that before any action was
taken he had communicated with the chief officers of the
asylums and of the Penitentiary and they had expressed
the opinion that such inspection would be very proper and
desirable. The section was approved ; but later Dr. .J. W.
Jones thought that the inspection of the stockades should
be made oftener than once a year, as frequently a stockade
was not in existence so long as a year, and in that event it
might not be inspected at all. An amendment was added
to the section, providing for inspection as much oftener as
requested by the "Board of Charities." The Secretary said
that he had considered the advisability of having the
superintendents of the public institutions make monthly
reports to the Board of Health, but as the}' have to keep a
record of these things any way, and include them in their
regular reports, he thought it not well to impose this duty
upon them.
Sec. 4. Approved without discussion.
Sec. 5. This section was amended so as to make eligible
to membership in the County Boards of Health all prop-erly
registered physicians.
Sec. 6. Dr. Hodges thought the law regarding fines
against Superintendents had been a dead law ; that he be-lieved
these fines had never been collected. He had at
times been delinquent in sending in his reports when he
was a Superintendent and had never paid a fine. The Sec-retary
explained that heretofore it had not been obligatory
on the Secretarv to notifv the Countv Commissioners of the
FIFTH BIENNIAL REPORT. 21
delinqiioiicy of the Supcniiteiulents. On motion the sec-tion
was amended, making it the duty of the Secretary of
the State Board to notify tlio Commissioners on the 11th of
each month of any delinquenx?.y on the part of Superin-tendents
to send in their reports by the 10th. As amended
the .section was adopted.
Sec. 7. This section, relating to the salaries of Superin-tendents
of Health, provoked a very great deal of discus-sion
by the members of the Conference generally. The
Secretary thought the salaries of these officers should be
imposed and regulated by legislative enactment so that
they could act independently in performing their duties.
There was a unanimity of opinion as to the fact that the
salaries of the Superintendents were far from satisfactory,
but there seeming to be an inabilitv to come to any con-elusion
as to the best and wisest plan for improving them,
Dr. Hodges moved that the matter be referred to a com-mittee
who should consider it and report at the afternoon
session. The motion was carried.
Sec. 8. The Secretary explained that this section was
introduced in its proposed form for the purpose of making
one definite day for the election of Superintendents in all
the counties of the State, and so that all terms of office
would expire at the same time. Dr. Thomas thought the
reason why local Boards of Health held such infrequent
meetings was because they were invested with no power
except to give advice and their advice generally resulted
in nothing. The section was adopted.
Sec. 9. Adopted.
Sec. 10. Adopted.
Sec. 11. Adopted.
Sec. 12. Adopted.
Sec. 13. Dr. Hodges thought we ouglit to deal with
great tenderness with the affairs of the public schools.
22 NORTH CAROLINA BOARD OF HEALTH.
Some committeemen lived ten miles apart, and it would
be bard to get tbem togetber to consider these tilings.
Tbe Secretary exrjlained that it was only tbe diseases tbat
were really dangerous to life tbat were included in tbis
section. The section is intended to apply especially to
city schools, but should also apply to county schools. Dr.
Grouse thought tlie last clause requiring tbe child wdio
persisted in coming to school while it was in dangerous
contact with contagious diseases at home, to be dismissed
from the school for the remainder of tbe term, a hardship
on tbe child and not a punishment on the pareut, where
the blame should rest. After some discussion it was
decided to leave tbis clause out, and as so amended the
section was passed.
Sec. 14. Adopted.
Sec. 15. Amended so as to provide for tbe early removal
of a suspect from tbe State, and was then adopted.
Sec. 16. Adopted after a slight amendment.
Sec. 17. This section was explained to refer to potable
waters. It was then adopted.
Sec. 18. Adopted after a slight amendment.
The remaining sections were adopted without much
discussion.
TJie Chair attempted to appoint the committee to take
into consideration the matter of salaries of Superintend-ents
of Health, but there were none willing to assume the
office, and on motion it was referred back to tbe whole
meeting for action and then postponed to the afternoon
session.
Tbe Conference then adjourned to o p. m.
FIFTH BIENNIAL KEPOKT. 23
AFTEKNOON SESSION.
The Contereiice \va.s called to order by the Chairman at
J o'clock.
Section 7, relating to salaries of Superintendents, was
introduced as the first order of business and again evoked
much discussion, with liual result of ado])ting the section
as it now stands.
The matter of taking some action luokmg to seeuriug
some law of compulsory vaccination elicited quite a spir-ited
debate. All present seemed to agree as to the desira-bility
of a more general practice of vaccination, but some
were doubtful as to the advisability of attempting to
secure legislation to require vaccination just at present, as
it might jeopardize the whole bill.
On motion the whole bill was adopted as a substitute
for the present Act Helating to the Board of Health.
By invitation Dr. W. G. Curtis, Quarantine Physician of
the station at the month of the Cape Fear river, read a
paper with a description of the station as it now is, a
recital of the needs of the station and a discussion of the
probability of cholera getting into this State the coming
summer.
During the latter part of the meeting Dr. Geo. G.
Thomas presided, as Col. Burgwyu was obliged to leave.
After the reading of Dr. Curtis's paper, which was lis-tened
to with much interest, the Conference adjourned
sine die. RICH'D H. LEWIS,
Secretary.
Upon request the President of the Senate and the
Speaker of the House announced a joint meeting of their
respective Committees on Public Health—the first com-mittees,
by the way, on public health ever appointed by
any Legislature in the history of the State, I am told—for
24 NORTH CAROLINA ROARD OF HEALTH.
the niglit aftor the adjournment of tlie Conference, to con-sult
with niemhors of the Board of Health in regard to
sanitary matters generally, and the proposed legislation in
the interest of the puhlic health in particular. Messrs.
Hodges, Venable, Thomas and the Secretary appeared
before them, and the bill was read over and explained.
Senator Lucas, of Bladen (;ounty. Chairman of the Senate
Committee on Public Health, who had just been appointed
on the Board by Governor Carr, took charge of the bill
and introduced it in the Senate. The Secretary again
appeared before the Senate Committee, to which it was
referred on its introduction, and it was favorably reported
with unanimity. He also had a number of personal inter-views
with Senators in regard to the importance of the act
and besides sent a letter with a copy of the act to about
one hundred physicians, County Superintendents and others,
urging them to use their influence with their Senators and
Representatives in effecting the passage of the bill.
This letter bore fruit, and after some delay and much
vexation of spirit on the part of your Secretary the bill
passed the Senate by a vote of thirty-four to eight, though
somewhat damaged by amendments. The House Com-mittee
unanimously recommended its passage. Notwith-standing
that fact when it came up on its second reading it
was laid on the table in short order by a considerable
majority, wdiich of course would have been the end of it but
for the tact and parliamentary skill of the Hon. Edmund
Jones, of Caldwell, a warm personal friend of 3'our Secre-tary,
who got it up again and with the active assistance of
a number of the best men in the House, medical and lay,
secured its passage. I was very anxious to have some of
the Senate amendments corrected in the House, but our
friends in that body advised strongly against attempting
anv amendment on the ground that if they ever began to
FIFTH BIENNIAL REPORT. 25
amend it it would probably come out in worse shape than
the Senate had left it. Your Secretary deferred to their
wisdom, feeling that it was better to take what we had than
to run a serious risk of losing much more.
The act as finally passed differs from that proposed by
the Health Conference essentially in these particulars: The
appointment of five members instead of three out of the
nine is given to the Governor and the term of office of all
is made the same, two j'ears—an unfortunate change, I
think, in both respects.
The annual appropriation of $3,000 asked for was cut
down to $2,000, the same as heretofore. In other respects
it is essentiallv as introduced.
On the whole we have made a decided advance, as a com-parison
of the new with the old lavr will clearly show, I
think. The old law, which was incorporated in the new,
was imjjroved in many respects and many new and valua-ble
sections, providing for much better protection against
the introduction and spread of contagious and infectious
diseases, and for the preservation of water su^^plies, as well
as improvements in other respects, were added. AVhile our
annual appropriation was not increased in dollars it was
materially augmented by the removal of the $250 limit to
our requisition on the State Printer for stationery and print-ing.
The emergency fund was also increased from $2,000
to $5,000. The following is the law as it now stands:
AN ACT IX RELATION TO THE BOARD OF HEALTH, RATIFIED
MARCH 1, 1893.
The General Assembly <>f Xortlt Carolina do enact
;
Section 1. That the Medical Society of the State of North Carolina
shall choose from its members by ballot four members, and the Governor
of the !^tate shall appoint five other persons (one of -whom shall be a
sanitary engineer) and they shall constitute "The North Carolina Board
of Health."
26 XOETH CAROLINA I50AKD OF HEALTH.
Sec. 2. The members of the Board of Health elected by the State Medi-cal
Society shall be chosen to serve two years. Their term of office shall
begin immediately upon the expiration of the meeting at which they
were elected. Those appointed by the Governor shall serve two years,
their term of otHce beginning with the first regular meeting of the Board
after their appointment. In case of death or resignation the Board shall
elect new members to fill the unexpired terms : Proridcd, the Governor
shall fill such vacancies as may occur where he has made appointments.
Sec. 3. Tliat the Xortli Carolina Board of Health shall take cognizance
of the health interests of the people of the State, shall make sanitary
investigations and inquiries in respect to the people, employing experts
when necessary ; shall investigate the causes of disease dangerous to tlie
public health, especially epidemics, the sources of mortality, the effect
of locations, employments and conditions upon the public health. They
shall gather such information upon ail these matters for distribution
among the people, with the especial purpose of informing them about
preventable diseases. They shall be the medical advisers of the State
and are herein specially provided for, and shall advise the government
in regard to the location, sanitary construction and management of all
State institutions, and shall direct the attention of the State to such sani-tary
matters as in their judgment affect the industries, prosperity, h.ealth
and lives of the people of the State. They may make an inspection once
in each year, and at such other times as they may be requested to do so
by the State Board of Charities, of ail public State institutions, including
all convict camps under the control of the State Penitentiary, and make
a report as to their sanitarj^ condition, with suggestions and recommenda-tions
to their respective boards of directors or trustees ; and it shall be
the duty of the officials in immediate charge of said institutions to fur-nish
all facilities necessary for a thorough inspection. The Secretary of
the Board sliall make biennially to the General Assembly, through the
Governor, a report of their work.
Sec. 4. The State Board shall have a President and a Secretary, wiio
shall also be Treasurer, to be elected from the members composing the
Board. The President shall serve two years and the Secretary-Treasiirer
two years. The Secretary-Treasurer shall receive such yearly compensa-tion
for his services as shall be fixed upon by the Board, not to exceed
one thousand dollars, but the other members of the Board shall receive
no pay, except that each member shall receive four dollars a day and
necessary traveling and hotel expenses when on actual duty attending
the meetings of the Board or pursuing special investigations in the State,
but when attending important sanitary meetings in other sections, the
number of delegates thereto being limited to two, only actual traveling
and hotel expenses shall be allowed. These sums shall be paid l>y the
Treasurer on authenticated requisition approved and signed by the Presi-dent.
FIFTH BIENNIAL REPORT. 27
Sec. 5. There shall be an auxiliary Board of Health in each county in
the State. These Boards shall be composed of all registered physicians
resident in the county, the ^layor of the county town, the Chairnian of
the Board of County Commissioners and the City Surveyor, when
there is such an otiicer; otherwise the County Surveyor. From this
number one physician shall be chosen by ballot to serve two years, with
the title of Superintendent of Health. His duty shall be to gather vital
statistics upon a plan designated by the State Board of Health. He shall
always promptly advise the Secretary of the State Board of tlie unusual
prevalence of disease in his county, especially of typhoid fever, scai'let
fever, diphtheria, yellow fever, small-pox, or cholera. His reports shall
be made regularly, as advised by the State Board, through their Sec-retary;
and he shall receive and carry out as far as possible such
work as may be directed by the State -Board of Health. He shall
make the medico-legal posf-rnorton examinations for coroners' inquests,
and attend the prisoners in jail, home for the aged and infirm, and house
of correction, and make an examination of lunatics for commitment. He
shall be the sanitary inspector of the jail and home of his county, mak-ing
monthly reports to the Board of County Commissioners : Provided,
that if for any cause tlie County Board of Health should fail to meet as
hereinafter set forth and elect a Superintendent, the County Commis-sioners
shall elect from those physicians resident in the county eligible
to membership in the County Board a Superintendent of Health : Pro-vidi'd
farther, that it shall be unlawful for said County Commissioners to
elect any one not eligible to membership in the County Board to the office
of County Superintendent of Health, if any such qualified physician can
be found in the county willing to accept the office.
Sec. 6. IMonthly returns of vital statistics, upon a plan to be made by
the State Board of Health, or their Secretary acting under their instruc-tions,
shall be made by the County Superintendent to the Secretai-y of
the State Board, and a failure to report by the tenth of the month for
the preceding month shall subject the delinquent to a fine of one dollar
for each day of delinquency, and this amount shall be deducted from
the salary of the Superintendent by the Boardof County Commissioners
on the statement of such delinquency by the Secretary of the State Board
of Health; and the said Secretary is hereby required to notify, on the
eleventh day of each month, the Chairman of the Board of County Com-missioners
of such delinquency. The County Superintendent shall report
to the Secretary of the State Board the presence in his county of any case
of small-pox, yellow fever, typhus fever or cholera within twenty-four
hours after it has come to his knowledge, and upon failure to make such
report within the prescribed time the County Commissioners shall
deduct five dollars from his salary for each day of delay in reporting.
Sec. 7. The salary of the County Superintendent of Health shall be
28 NORTH CAROLINA BOARD OF HEALTH.
paid out of the county treasury upon requisition and the proper
vouchers as follows: The salary of the Superintendent of Health, or
any other member of the Board who is requii-ed to do the service
assigned him, sliall be in accordance witli the medical fees usual in his
county, and for each inspection of the jail and county home, which he
shall make monthly, he shall be paid as for one medical visit : Prodded,
that a definite salary of not less than ten nor more than one thousand
dollars may be paid in lieu of fees if mutualh^ agreeable to the Board of
County Commissioners and the County Superintendent.
Sec. 8. The biennial meeting for the election of officers shall be, for
the State Board of Health, on the second day of the annual meeting of
the Medical Society of tlie State of North Carolina in eighteen hundred
and ninety-three and every two years thereafter; for the County Boards
it shall be held in the county court-house between the hours of 12 >f.
and 1 V. y\. on the first Monday in September, eighteen hundred and
ninety-thi-ee, and each two years thereafter: Frurided, that the two-year
term of office of any Superintendent shall not be curtailed thereby
;
but his successor, who shall be elected at the meeting on the first Mon-day
in September, eighteen hundred and ninety-tiiree, shall qualify upon
the expiration of said term and hold office until the first Monday in
September, eighteen hundred and ninety-five, Mhen all County Superin-tendents
shall be elected for the full term of two years, beginning and end-ing
with the first ^Monday in September. In order to secure uniformity
and certainty of action it shall be the duty of the Secretary of the State
Board of Health to mail to every person in the State eligible to member-ship
in the County Boards of Health, whose address can be obtained, on
or before the twentieth day of the August next preceding the time of meet-ing
hereinbefore appointed, a printed notice of said meeting setting forth
time and place.
Sec. 9. Inland quarantine shall be under the control of the County
Superintendent of Health, who shall see that diseases especially dan-gerous
to the public health, viz., small-pox, diphtheria, scarlet fever,
yellow fever, typhus fever and cholera, are proj)erly quarantined and iso-lated
within twenty-four hours after the ca.se is brought to his knowledge ;
and that after the death or recovery or removal of a person sick of either
of the diseases mentioned the rooms occupied and the articles used by
the patient are thoroughly disinfected in the manner set forth in the
printed instructions, both as to quarantine and disinfection, which shall
be furnished him by the Secretary of the State Board of Health. The
expense of the quarantine and of the disinfection shall be borne by the
householder in whose family the case occurs, if able; otherwise by the
city, town or county of which he is a resident. The failure on the part
of a County Superintendent of Health to perform the duties imposed in
this section shall be punished by the deduction of five dollars for each
FIFTH BIENNIAL REPORT. 29
day of delinquency from his salary by the Board of County Commis-sioners
; and if it shall appear to the satisfoction of the County Board
of Health that the death of any person from the spread of the disease
can justly be attributed to such failure of duty on his part, he shall be
deposed from office and a successor immediately elected to fill out his
unexpired term. Any person neglecting or refusing to comply with or
in any way violating the rules promulgated in the manner above set
forth on the subjects of quarantine and disinfection shall be deemed
guilty of a misdemeanor, and upon conviction shall be fined or impris-oned,
at the discretion of the court, not less than five nor more than
fifty dollars, or less than ten nor more than thirty days. In case the
offender be stricken with the disease for which he is quarantinable, he
shall be subject to the penalty on i-ecovery, unless in the opinion of
the Superintendent it should be omitted : Provich-d, hoirerer, that in any
city or incorporated town having a regularly appointed medical health
officer who is a member of the County Board of Health, the duties
assigned in this section to the County Superintendent of Health shall be
performed by the said medical health officer for the people of his city
or town, and he shall be subject to the same penalties for dereliction of
duty at the hands of the Board of Aldermen or Town Commissioners as
are directed to be imposed by the County Commissioners and County
Board of Health upon the Superintendent: Frotided further, that the
quarantine of ports shall not be interfered with, but the officers of the
local and State Boards shall render all aid in their power to quarantine
officers in the discharge of their duties upon the request of the latter:
Provided, tliat the custody and care of any child or other person may
remain in custody of parent or family.
Sec. 10. Wiien a householder knows that a person within his family
is sick with either of the diseases enumerated in section nine he shall
immediately give notice thereof to the health officer or Mayor, if he
resides in a city or incorporated town, otherwise to the County Superin-tendent
of Health, and upon the death or recovery or removal of such
person the rooms occupied and the articles used by him shall be disin-fected
by such householder in the manner indicated in Section Nine.
Any person neglecting or refusing to comply with any of the above pro-visions
shall be deemed guilty of a misdemeanor, and upon conviction
shall be fined not less than one dollar nor more than fifty dollars.
Sec. 11. When a physician knows that a person whom he is called to
visit is infected with small-pox, diphtheria, scarlet fever, typhus fever,
yellow fever or cholera he shall immediately give notice thereof to the
health officer or :\Iayor, if the sick person be in a city or incorporated
town, otherwise to the County Superintendent of Health, and if he
refuses or neglects to give such notice of it in tv\enty-four hours he shall
be guilty of a misdemeanor and shall be fined for each offen-e not less
30 NORTH CAROLIXA BOARD OF HEALTH.
than ten nor more than twenty-five dollars. And it shall be the duty
of the said County Superintendent, health officer or 3Iayor receiving
such notice of the presence of a case of small-pox, yellow fever, typhus
fever or cholera within his jurisdiction to communicate the same
immediately by mail or telegraph to the Secretary of the State Board of
Health. A failure to perform this duty for twenty-four hours after the
receipt of the notice shall be deemed a misdemeanor, and shall subject
the delinquent njton conviction to a fine of not less than ten nor more
than twenty-five dollars.
Sec. 12. The County Superintendents of Health, or the Boards of Health
in the several cities and towns where organized, otherwise the authoi'i-ties
of said cities or towns, shall cause a record to be kept of all reports
received in pursuance of the preceding sections, and such records shall
contain the names of all persons who are sick, the localities in which
tiiey live, the diseases with which tliey are alfected, together with the
date and names of all persons reporting any such cases. The Boards of
Health of cities and towns wherever organized, and where not the
Mayors of the same, and in other cases the County Superintendent of
Health, shall give the .school committee of the city or town, the princi-pals
of private schools and the Superintendent of Public Instruction of
the county, when the schools are in se.'^sion, notice of all such cases of
contagious diseases reported to them according to the provisions of this
act. A failure to perform this duty for twenty-four hours after the
receipt of the notice shall be deemed a misdemeanor, and subject the
delinquent upon conviction to a fine of not less than ten nor more than
fifty dollars.
Sec. Ii5. The school committees of public schools, superintendents of
graded schools and the principals of private schools shall not allow any
pupil to attend the school under their control while anj^ member of the
household to which said pupil belongs is sick of either small-pox, diph-theria,
measles, scarlet fever, yellow fever, typhus fever or cholera, or
during a i)eriod of two weeks after the death, recovery or i-emoval of
such sick person ; and any pupil coming from such household shall be
required to present to the teacher of the school the pupil desires to
attend a certificate from the attending physician, city health officer or
County Superintendent of Health of the facts necessary to entitle
him to admission in accordance with the above regulations. A wilful
failure on the part of any school committee to perform the duty required
in this section shall be deemed a misdemeanor, and upon conviction
shall subject each and every member of the same to a fine of not less
than one nor more than twenty-five dollars : Provided, that the instruc-tions
in accordance with the provisions of this section given to the
teachers of the schools within twenty-four hours after the receipt of each
and every notice shall be deemed performance of duty on the part of
FIFTH BIEXXIAL REPORT. 31
the school committee. Any teacher of a i)ublic school and any ]n-inci-pal
of a private school failing to carry out the requirements of this sec-tion
shall be deemed guilty of a misdemeanor, and upon conviction shall
be lined not less than one nor more than twenty-tive dollars.
Sec. 14. When a person coming to a city or town from abroad or from
some other place in this State is infected or has lately been infected with
either of the diseases mentioned in Section Nine the local Board of
Health where such exists, otherwise the Board of Aldermen or Board
of Town Commissioners, shall make effective provision in the manner
which it judges best for the safety of the inhabitants by removing such
person to a separate house or otherwise, and by providing nurses and
other assistance and necessaries, whicii shall be at the charge of the
person himself or hisixirents, where able, otlierwise at the charge of the
city, town or county to which he belongs.
Sec. 15. The Board of Health, or, in case there is no Board of Health,
the Board of Aldermen or Town Commissioners of a city or town near
to or bordering upon either of tb.e neighboring States, may appoint, by
writing, suitable persons to attend at places by whicii travelers may pass
from infected places in other States, who may examine such travelers as
may be suspected of bringing any infection dangerous to the public
health, and if it need be may restrain them from traveling until licensed
thereto by the Board of Healtii or Board of Aldermen or Town Com-missioners
of the city or town to which they maj' come. A traveler
coming from such infected places who, without such license, travels within
this State (except to return by the most direct route to the State whence
he came) after he has been cautioned to depart by the persons so
appointed, shall be isolated or ejected, at the discretion of the local city
or town or county Board of Healtii ; and upon refusal to comply with
the regulations of the said Boards of Health or either of them on this
subject shall be guilty of a misdemeanor, and upon conviction shall be
fined not less than twenty-five nor more than fifty dollars or imprisoned
not more than tliirty days. And all common carriers bringing into this
State any such persons as named above are hereby required to return
them to some point without this State, if required by a city, town or
county Board of Health. Nothing in this section shall prevent the State
Board of Health in time of epidemics from appointing such additional
examiners as they may deem necessary to the preservation of the public
health.
Sec. 16. No railroad corporation or other common cari-ier or person
shall convey or cause to be conveyed through or from any city, town or
county in this State the remains of any person who has died of small-pox,
measles, scarlet fever, diphtheria, typhus fever, yellow fever or
cholera until such body has been disinfected and encased in such manner
as shall be directed by the State Board of Health, so as to preclude any
32 NORTH CAROLINA BOARD OF HEALTH.
danger of (.•oinmnnicatiiig the disea^^e to others by its transportation ; and
no local registrar, clerk or heaUli otlicer, or any other person, shall give
a permit for the removal of such body until he has received from the
Board of Health of the city, or from the Board of Aldermen or Town
Commissioners, or the County Superintendent of the city, town or county
where the death occurred, a certificate stating the cause of death and
that the said body had been prepared in the manner set forth in this
section; which certificate shall be delivered in duplicate to the agent or
person who receives the body, and one copy shall be pasted on the box
containing the corpse ; said certificate shall be furnished in blank by the
transportation company wh.en no local board of health exists. During
an epidemic of cholera all common carriers shall so arrange their water-closets
as to catch in water-tight receptacles the dejections of all persons
using the same and shall disinfect the said dejections in a manner satis-factory
to the State Board of Health befoi'e emptying them. Any person
violating the provisions of this section shall be punished by fine not
exceeding twenty-five dollars.
Sec. 17. In times of epidemics of small-pox, yellow fever, typhoid
fever, scarlet fever, diphtheria, typhus fever, cholera, the State Board of
Health shall have sanitary jurisdiction in all cities and towns not having
regularly organized local boards of health, and are hereby empowered to
make all such regulations as they may deem necessarj- to protect the
public health, and to enforce, in courts of justices of the peace, the same
by the imposition of sucii penalties as come within tlic jurisdiction of a
justice of the peace.
Sec. is. Water and icater siipph/.—The State Board of Health .shall liave
the general oversight and care of all inland waters and shall from time to
time, as it may deem expedient, cause examinations of the said waters to
be made for the purpose of ascertaining wliether the same are adapted
for use as sources of domestic water sui)])lies, or are in a condition likely
to iiupair the interests of the public or persons lawfullj' using the same,
or imperil the public health. For the purpcses aforesaid it may employ
such expert assistance as may be necessary.
Sec. li). The said Board shall from time to time consult with and advise
the boards of directors of all State in.stitutions, the authorities of cities
and towns, corporations or firms already having or intending to introduce
systems of water supply, drainage or sewerage, as to the most appropriate
source of supply, the best practicable method of assuring the purity
thereof, or of disposing of their drainage or sewerage, having regard to
the present and prospective needs and interests of other cities, towns,
corporations or firms which may be affected thereby. All such boards
of directors, authorities, corporations and firms are hereby required to
give notice to said Board of their intentions in the premises and to sub-mit
for its advice outlines of their jnoposed plans or schemes in relation
FIFTH BIENNIAL RKPOKT. So-to
water .sni)ply and dis}n)sal of sewage, and no contraet sliall be entered
into by any State institution, city or town for the introduction of a sys-tem
of water supply or sewage dis})osal until said advice shall have
been received and considered: Pruriiled, Jiou-frcr, that any city or town
having a regularly organized Board of Health may seek advice therefrom
or from its County Boai'd of Health in lieu of that of the State Board.
Sec. 20. "Whoever willfully or maliciously defiles, corrupts or makes
impure any well, spring or otlier .source of water supply or reservoir, or
destroys or injures any pii)e, conductor of water or other property per-taining
to an aqueduct, or aids and abets in any such trespass, shall be
guilty of a misdemeanor, and on conviction shall be fined not exceeding
one thousand dollars or imprisoned not exceeding one year.
Sec. 21. Any hou.seholder in whose family there is to his knowledge a
person sick of cholera or typhoid fever, who shall permit the bowel dis-charges
of such sick person to be emptied without first having disinfected
them according to the instructions to be obtained from the attending
physician or the County Superintendent of Health shall be guilty of
a misdemeanor, and upon conviction shall be fined not less than two nor
more than twenty-five dollars, or imprisoned not less than ten norjnore
than thirty days. And in cases where such undisinfected discharges are
emptied on the water shed of any stream or pond furnishing the source
of water supply of any public institution, city or town the penalty .shall
be a fine of not less than twenty-five nor more than fifty dollars, or
imprisonment for not more than thirty days. And any i)hysician attend-ing
a case of cholera or typhoid fever who refuses or neglects to give the
proper instructions for such disinfection as soon as the diagnosis is made
shall be deemed guilty of a misdemeanor, and upon conviction shall be
fined not less than ten nor more tlian fifty dollars.
Sec. 22. Whenever and wherever a nui.sance upon premises shall exist
which in the opinion of the County Superintendent of Health is danger-ous
to the public health, it shall be his duty to notify in writing the
parties occupying the premises (or the owner, if the premises are not
occupied) of its existence, its character and the means of abating it. X^pon
this notification the pjarties shall proceed to abate the nuisance, but fail-ing
to do this shall be adjudged guilty of a misdemeanor and shall pay a
fine of one dollar a day dating from twenty-four hours after the notifica-tion
has been served, the amounts so collected to he turned over to the
County Treasurer: Prodded, hoiren'r, that if the party notified shall
make oath or afiirmation before a justice of the peace of his or her
inability to carry out the directions of the Superintendent it shall 1)6
done at the expense of the town, citj' or county in which the offender
lives. In the latter case the limit of the expense chargeable to the town^
city or county shall not be more than one hundred dollars in any case:
ProriV/cr^ /*);//(('/•, that nothing in this section shall be construed to give
34 NORTH CAROLINA BOARD OF HEALTH.
the Supcriiiteiident the power to destroy or injure property without a
due process of law as now exists for the ahatement of nuisances.
Sec. 2;]. Vaccinatioii.—On the appearance of a case of small-pox in
any neighhorhood all due diligence shall be used by the Superintendent
of Health that warning shall be given, and all persons not able to pay
shall be vaccinated free of charge by him, and the County Superin-tendent
shall vaccinate every person admitted into a public institution
(jail, county home, public school) as soon as practicable, unless he is
satisfied ujion examination that the person is already successfully vac-cinated
; the money for vaccine to be furnished by the County Commis-sioners.
The authorities of any city <»r town, or the Board of County
Commissioners of any county, may make such regulations and provis-ions
for the vaccination of its inhabitants under the direction of the
local or county Board of Health or a committee chosen for the purpose,
and impose such penalties as they may deem necessary to protect the
public health.
Sec. 24. The Board of County Commissioners of eacli county is hereby
authorized at any time to call a meeting of the County Board of Magis-trates
or Justices of the Peace to take into consideration the health
interest of the people of their county, and, with the approval of the
said Board of Magistrates, to levy a special tax to be expended under
the direction of a committee composed of the Chairman of the Board
of County Commissioners, the Mayor of the county town and the
County SuiJerintendent of Health for the preservation of the public
health.
Sec. 25. The authorities of any city or town are hereby authorized,
not already authorized in its charter, to make such regulations, pay such
fees and salaries and impose such penalties as in their judgment may be
necessary for the protection and the advancement of the public health.
Sec. 26. Bulletins of the outbreak of disease dangerous to the pul)lic
health shall be issued by the State Board whenever necessary, and such
advice freely disseminated to prevent and check the invasion of disease
into any part of the State. It shall also be the duty of the Board to
inquire into any outl^reak of disease by personal visits or Ity any
method the Board shall direct. The compensation of members on such
duty shall be four dollars a day and all necessary traveling and hotel
expenses.
Sec. 27. Special meetings of the State Board of Health may be called
by the President through the Secretary. The regular annual meetings
shall be held at the same time and place as the State Medical Society,
at which time the Secretary shall submit his annual report.
Sec. 28. For carrying out the provisions of this act two thousand
dollars, or so much thereof as may be necessary, are hereby annually
appropriated, to be paid on requisition to be signed by the Secretary
FIFTH BIKXXIAF. KK1N)1;T. '.\~)
ami President of the State Board of Health ; and tlif printhiii: and s^ta-tionei'y
necesFary for tlie board to be furni.shed ui)on requisition upon
the State Printer. A yearly statement shall be made to the State
Treasurer of all mone}'s received and expended in pursuance of this act.
Sec. 29. A contingent fund of five thousand dollars is herel)y appro-priated,
subject to the (iovernor'.s warrant, conntersigned and recorded
by the Auditor of the State, to be expended in pursuance of the provis-ions
of this act wlien rendered necessary by a visitation of cholera or
any other pestilential disease.
Sec. 30. All previous acts conflicting witli this act, and also all previous
acts of appropriation for the jjublic health, are hereby repealed upon
the passage of this act: Frovidt'd, that nothing herein shall operate as
a repeal or abridgment of powers conferred by any special act on any
local Board of Health.
Sec. 31. Tliat this act shall be in force from and after its ratification.
Ratified the 1st day of March, A. D. 1893.
On Januaiy 27th letters with new blanks to be used for
monthly reports were sent to all Connt}^ Superintendents
and town reporters.
On March 10th a letter and blank were sent to every
Clerk of tlie Superior court in the State asking for a list of
all the registered physicians in each county.
On the 28th of March a second letter was sent to thirty-one
Clerks who had not responded to first letter.
On April 4th a letter of acknowledgment, together with
a copy of the "Laws Regulating the Practice of Medicine
in North Carolina," was mailed to all Clerks who had sent
in lists.
This letter explained to them the requirements for regis-tration,
as the lists showed some illegal registrations had
been made.
While the administration of the laws regulating medical
practice does not come technically within the jurisdiction of
the Secretary of the State Board of Health it has a sufficient
bearing on the health of the people, he thinks, to justify his
action in availing himself of an opportunity to probably
correct some errors in. the registration of physicians tr.at had
3(5 NORTH CAROLINA BOARD OF HEALTH.
been made—an-l to prevent tlieir occurrence in the future,
by calling the attention of the Clerks of Court especially to
the law as it now stands. It is gratifying to know that his
efforts were appreciated, by some of the Clerks at any rate,
and that one to his certain knowledge recalled certificates
which under a misapprehension had been incorrectly issued.
In response to a call for a Conference of State Boards of
Health to be held in N(,'W York on April 5, 1893, to consult
upon the conditions of the quarantine stations of the coun-try
and other matters pertaining to keeping out pestilential
diseases, the President and Secretar}- attended as delegates
from this Board.
The principal business accomplished by this Conference
over and above the good resulting from personal contact
and interchange of ideas is set forth in the published report
of the Secretary of that body.
On April 12tli your Secretary received this letter:
WiLMixGTOX, N, C, April 11, 1893.
Dr. R. 11. Lewis, Secretary State Board of Health, Raleigh, X. C,
DeaeDoctor:—TheQuarantineBoardof the port of Wilmington respect-fully
submit that, in view of the opinion expressed bj' the Conference of
Health Officers that the emergency demanded the erection and operation
of disinfecting plants at seaport towns, the State Board of Health take up
the question and consider the advisability of making available the appro-priation
made for this port by the last Legislature.
Respectfully,
GEO. GILLETT THOMAS,
Secretary Board of Quarantine, Fort of Wilmington, N. C.
In consequence thereof I addressed the following letter to
each member of the Board of Health, inclosing a copy of
Dr. Thomas's letter with an abstract of the minutes of the
Conference and of the legislative act making the appro-priation
:
FIFTH r.IKNXIAL REPORT. 37
Raleigh, N. C, April 14, 1893.
Dear Doctor:—I have just received the following letter from the Sec-retary
of the Board of Quarantine of the port of Wilmington: "The
Quarantine Board of the port of Wilmington respectfully submit that, in
view of the opinion expressed l>y the Conference of Healtli Officers that
the emergency demanded the erection and operation of disinfecting
plants at seaport towns, the State Board of Health take ujj the question
and consider the advisability of making available the appropriation made
for this port b}' the last Legislature."
The following is an extract from a report of the proceedings of the
Conference: "Dr. H. B. Baker, of Michigan, offered the following,
which was unanimously adopted :
^ liesolred, That in the present emer-gency
every State maintaining a maritime quarantine should possess a
perfectly equipped station with all appliances necessary for thorough
disinfection of infected vessels, unless there are special reasons to the
contrary.' The last clause was added to cover the case of States like
New Jersey, whicli can avail themselves of the stations of neigldioring
States."
As this is a matter of urgent imi^ortance, in order to save delay and
the necessity of a special meeting of the Board so near the time of the
regular meeting on the 10th pi'ox., I would thank you for an immediate
expression of opinion by letter on the question. If a majority of tlie
Board reply in the afiirmative, and the Governor approves, the Quarantine
Board would feel authorized to give out the contracts at once, and more
regular action could be taken by the Board of Health when it meets, if
deemed necessary.
The facts on which the above letter is based are these : The last Legis-lature
appropriated •'?20,000 for a modern disinfecting jilant at Southport,
which now has none at all, but attached the condition that the money
should not be available until "in the opinion of the Governor and the State
Board of Health the entrance of cholera into the port is imminent."
Upon the construction of the word "imminent" hangs the decision. In
Worcester's Comprehensive Dictionary the word "imminent" is detined
"impending; threatening; near," tlie only meanings given. In th.e opin-ion
of the recent Conference alluded to in the letter quoted cholera is
"impending; threatening; near," as it doubtless is in the oi)inion of
nearly every other person of any sanitary experience, owing to our con-stant
intercourse with western FAirope. In this case the word imminent
could not be taken to mean something "about to fall on the instant,"
for it would be manifestly absurd to wait until a ship with cholera on
board had entered the mouth of the Cujie Fear before giving out the con-tract
for apparatus requiring two or three months for its construction to
prevent the entrance of the disease. So that in the opinion of the under-signed,
as well as of two other members of the Board with whom he has
38 XOIITH CAROLINA KOARD OF HEALTH.
spoken, "the diiiigev of the entrance of cholera into the port of Wilming-ton
is imminent" in the sense in which the word can alone be reasonably
applied to the case in hand. Please let me know by return mail whether
yon agree or disagree with that opinion. Not a day is to be lost if any
thing is to be done.
Very truly yours,
RICH'D H. LEWIS,
Secrrtary.
To tliis ictter replies were received from all the members,
only one opposing the approi)riation. As soon as a majority
had been heard from, reahzing the importance of getting to
work on the Quaraiitine Station at the earliest possible
moment, I wrote to his Excellency Governor Carr, who
was then at Rocky Mount, which letter was delayed in
reaching him. Immediately npon his return to the capital
I laid the matter with the correspondence before him. He
appointed an hour the same afternoon for me to call for his
decision, but before it arrived he was unexpectedly sum-moned
to Newbern. On his return, having received replies
from every member of the Board, I addressed to him this
communication:
May ], 1893.
His Excellency Elias Carr, Governor of Xorili Cnroluia,
Sir:—Since my communication of the 17th ult., addressed to you at
Rockj'^ Mount, stating that "replies from a majority (of the Board of
Health) expressing the opinion that 'the entrance of cholera into the
portof Wilmington as imminent' had been received," I have heard from
every member. The replies from eight are as above, and from one to the
effect that the entrance of cholera is no more imminent now than at the
time of the passage of the act. I beg to dissent from that oiiinion, for the
reason that a number of fresh cases have occurred on the west coast of
Europe since the adjournment of the Legislature, and sanitarians now
consider the outlook for the summer very gloomy.
The Quarantine Board of Wilmington now awaits the concurrence of
your Excellency in the opinion of the State Board of Health, a.s required
by the act, before beginning this work of such great importance in pro-tecting
the port and State from, the scourge which threatens us. With
great respect, Your obedient servant,
IlIOK'D H. LEWLS,
Secretary.
FIFTH BIENNIAL KEPORT. o9
To this letter the Governor rei:)lied as follows:
May 1, 1893.
Dr. Richard H. Lewis, Secretanj X. C. Board of Health, Raleigh, N. C
,
Dear Sir:—Eeplying to j'our kind favor of the 1st instant, I would
state, in accordance with your views and the other members of the State
Board of Health, and after viewing the situation as it is, that, section 2 of
the act to amend section 2915 of The Code as follows : "For the purpose of
carrying into effect the provisions of section 2915 as herein amended the
sum of twenty thousand (?20,000) dollars is hereby appropriated out of
any moneys in the State Treasury not otherwise appropriated, to be paid
from time to time, as required in the prosecution of the work, on the
requisition of the Treasurer of the Quarantine Board and aj)proved by
its President: Provided, that the funds appropriated by this act shall
not be paid over by the Treasurer until the Governor and State
Board of Health of North Carolina shall certify to the Treasurer that
there is imminent danger of cholera visiting the city of AVilmington or
other sections of the State," makes it my plain duty to inform j^ou that
the amount appropriated ($20,000) is now available, and can be used
in carrying out the pi-ovisions of the act.
With highest esteem, I am, Yours very truly,
ELIAS CARE,
(rorernor.
I immediately wired the Secretary of the Quarantine
Board of AVilmington:
Govei'nor approves. Go ahead. If. H. LEWIS,
Secretary.
Afterwards I wrote him as i'oilows :
May 2, 1893.
Dr. Geo. G. Thomas, Secretary Board of Quarantine, Port of Wllmingtoii,
My' dear Doctor:—In compliance with your communication of the 11th
ult., calling upon the State Board of Health to "take up the question
and consider the advisability of making available the appropriation
made for the port by the last Legislature," I addressed a letter setting
forth the facts to each member of the Board. Replies from all v>ere
duly received—eight voting in favor and one against complying with the
condition necessar\' to make the appropriation available.
The whole correspondence was laid before his Excellency, the Gov-ernor,
at the earliest opportunity, and to-day I received his decision. I
inclose his letter, w'hich, after submitting it to your Board, you will
please return and oblige.
Yours trulv.
RICH'D H. LEWIS, :\I. D.,
3 Secretary.
40 NORTH CAROLINA BOARD OF HEALTH.
While the securing of a quaruutine station with all the
modern improvements for our chief seaport, a work of the
liighest value, from a sanitary point of view, to the State,
•cannot be credited to our Board, it is gratifvino- to know
that the leader in that movement was one of our members.
Dr. George G. Thomas, who v\'as most ably assisted by Dr.
T. S. Burbank, Messrs. J. C. Stevenson, Alex. Sprunt and
•others. Thanks to their efforts and to our enlightened and
progressive Legislature North Carolina will soon be abreast
of the most advanced communities in the matter of mari-time
quarantine protection.
In the performance of the duty imposed upon me in
Section 9 of the Act Relating to the Board of Health I
prepared the following 23amphlet containing Instructions
for Quarantine and Disinfection :
INSTRUCTIONS FOR QUARANTINE AND DISINFECTION.
EXTRACT FROM SECTION NINE OF AN ACT RELATING TO THE BOARD
OF HEALTH, RATIFIED MARCH i, 1S93.
"Iiilaud quarantine shall be uuder the control of the County Superintendent of
Health, who shall see that diseases especially dangerous to the public health, viz.:
small-pox, diphtheria, scarlet fever, yellow fever, typhus fever and cholera, are prop-erlj'
quarantined and isolated within t\vent3--four hours after the case is brought to his
knowledge; and that after the death or recovery' or removal of a person sick of either
of the diseases mentioned, the rooms occupied and the articles used by the patient are
thoroughlj- disinfected in the manner set forth in the printed instructions, both as to
quarantine and disinfection, which shall be furnished him bj' the Secretary of the
State Board of Health. The expense of the quarantine and of the disinfection shall be
t>orne by the householder in whose family the case occurs, if able, otherwise by the cit}',
town or county of which he is a resident. * * * Any person neglect-ing
or refusing to comply with or in any way violating the rules promulgated in the
manner above set forth on the subjects of quarantine and disinfection shall be deemed
guiltj- of a misdemeanor, and upon conviction shall be fined or imprisoned, at the dis-cretion
of the court, not less than five nor more than fifty dollars, or less than ten nor
more than thirtj' daj's. * * * In any city or incorporated town having a regularly
appointed medical health officer who is a member of the County Board of Health, the
duties assigned in this section to the Count}' Superintendent of Health shall be per-formed
by the said medical health officer for the people of his city or town. * * * "
1. Every person sick of either of the diseases mentioned in the above
•extract from section nine should be immediately isolated, with his nurses,
in a separate room, if there is one. and nothing: should be taken out of
FIFTH BIENNIAL REPORT. 41
such room at any time without having been previousl}' disinfected in the
manner described under the head of disinfection. The mildness of the
attack must not be laermitted to beget laxity in carrying out these
hist ructions.
2. When any of the diseases mentioned above occurs in a house con-taining
only one room, the house and all persons residing therein should
be quarantined. The same rule should apply to the entire house, even
if of sufticient size to permit the isolation of the sick person and his
nurses in a separate room, in cases of small-pox, cholera, yellow fever,
and typhus fever; but in cases of scarlet fever and diphtheria the quar-antine
need extend only to the room occupied by the patient and his
luirses and to the occu])ants thereof Whenever possible persons sick of
small-pox, cholera, typhus fever or yellow fever should be immediately
removed to quarters specially provided for the detention and treatment
of such cases. Particular care should be taken to quarantine for a time
sufficiently long to insure safety to others all persons who were exposed
to infection before the removal of the patient.
3; When a house or room is in quarantine no one whatever except the
.attending physician and the clergyman of the family slsould be admit-ted.
The person doing the outside service for a quarantined family
should take orders verbally from a distance, and should lay down at the
entrance of the house or room any aiticles he may bring there. Xo pet
•dog or cat should be allowed in the room.
4. When either of the diseases mentioned has declared itself in a
house no work for trade purposes or for private families should be taken
in by any one inhabiting the same, and all such work as may have been
taken in before the outbreak of the disease should be disinfected before
being sent home.
5. !Xo person recovering from either of these diseases, and no person
who has nursed such a patient, should quit the house before receiving a
certificate from the County Superintendent of Health, municipal medi-cal
health officer, or attending physician, that the precautions required
under the head of disinfection have been taken. Children must have
certificate before re-entering school. See section 13 of the law.
6. No person residing in a quarantined house should go beyond the
lot (or farm, provided there be no other })ersons living thereon) or put
himself in direct communication with any one from outside.
7. When a house is quarantined any person residing therein, other
than the patient, who wishes to leave for tlie purpose of changing his
residence, may do so with the written permission of the County Super-intendent
of Health or municipal medical health officer, provided he
takes all the precautions required under disinfection.
8. The body of every person who has died of either of the diseases
mentioned should be disinfected in the manner described below. It
42 XOKTH CAROLINA BOAKD OF HEALTH.
should be kept isolated up to the moment of the funeral in the room
occupied by such person during his illness. The funeral should take
place as soon as possible, and in all cases be private, attended only by
those absolutely necessary to the proper performance of the burial,
unless the body having been disinfected be in a metal coffin hermetically
sealed. Children should under no circumstances be present.
9. When there is a case of either of the diseases mentioned in a house
a placard stating the name of the disease, to be furnished by the County
Superintendent of Health, shall be posted on the front door of said
house. This placard must not be removed in any case until the jjremises
have been properly disinfected, and then only by the County Superin-tendent
of Health or municipal medical health officer in per.son, or by
exjiress permission of the same.
DISINFECTIOX.
I. DURING THE CONTINUANCE OF THE DI.SE.\SE.
{a). All the sunlight possible and as much fresh air as the nature of
the disease and the state of the weather will permit should be admitted
to the sick-room.
(/)). The expectorations and evacuations of the patient should be received
in vessels in which there is a considerable quantity of bichloride of
mercury, solution Xo. 2, or milk of lime, or an equal quantity of either
of them should be added thereto and the mixture allowed to stand at
least a half hour before throwing into the water-closet, if the house be
connected with a system of sewers, or, otherwise, should be buried at a
distance of not less than 100 feet from any well or spring.
(c). Soiled body and bed-clothing, handkerchiefs, rags, etc., should, as soon
as discarded, be immediately burned or immersed in a vessel of suffi-cient
size, containing enough of the zinc or chloride of lime solution
to completely cover them, and kept there until they can be thoroughly
boiled for not less than a half hour in plain water, or better the zinc
solution, and then washed and dried in the sun.
(fZ). The remains of the food served to the patient should be burned
in the room or soaked in one of the disinfecting solutions mentioned
and then buried.
II. AFTER THE RECOVERY, REMOVAL OR DEATH OF THE PATIENT.
(a). Of the articles used and room occupied by the patient. The vessels
should be washed with a disinfecting solution. Burn in a hot fire suffi-ciently
fierce to consume quickly and completely such articles as are not
too valuable. Others that can be boiled without injurv should be boiled
hard for not less than a half hour, then thoroughly washed and dried in
the sun. The remainder—furniture, curtains, woolen clothes, pillows,
beds, mattresses (the contents of mattresses when straw, shucks or other
FIFTH BIENNIAL REPORT. 43
cheap material should be burned and the ticks boiled) and all other
articles which have been exposed to the infection should be hung on
racks, or otherwise looselj^ distributed about the room, so as to permit
free access of the gas to every part, the carpet, if there be one, being
left on the floor, and then disinfected at the same time with the room by
sulphur fumigation. Afterwards they should be taken into the open air
and thoroughly beaten and sunned.
If preferred, in cases where every article in the room can be subjected
to the process to be named, or when the I'oom cannot be made tight
enough to retain the sulphur fumes, every article in the room which can
be should be boiled and the remainder, including the floor and wood-work,
should be well washed with the bichloride solution No. 1. The
walls and ceiling should have the same solution thorouf/JiIy applied to
them or be well whitewashed.
{b). Of the. person of the recovered patient. Wash the body, including
the hair, with the bichloride solution No. 1 and put on clean clothes
that have not been in the sick-room or that have been disinfected as
prescribed in 1 (c).
(e). Of the dead hodij. Wrap the bod}' in a well-sewed sheet thoroughly
saturated with the bichloride solution No. 2 or with the chloride of lime
solution. Put two pounds of chloride of lime in the coffin.
(fO- Qf persons before leacing a house ivhicJi ]ias been, qnarantoied. Wash
at least the uncovered portions of the body—hands, face, beard and hair
—better the entire body—in the bichloride solution No. 1 and put on
clean clothes that have not at any time been exposed to the infection or
have been disinfected in the manner described. The notice of the attend-ing
physician and visiting clergyman is called to the importance of their
observing these precautions and at least washing their hands in the
bichloride solution the last thing before leaving the room.
{e). Of a vehicle used to carry the body, living or dead, affected witJi either
of the diseases enumerated. Remove all cushions, curtains and other acces-sories
and disinfect by boiling or soaking in the bichloride solution No. 1
and wash out the interior with bichloride solution No. 2.
DISINFECTANTS.
1. Bichloride of mercury, solutinn No. 1. Bichloride of mercurj' 1
drachm, water 1 gallon.
2. Bicldoride of mercury, solution Xo. 2. Two drachms to the gallon.
Owing to its poisonous character a solution of bichloride should be col-ored
w itii bluing to prevent mistakes. It should be kept in earthen or
wooden vessels, as it corrodes metals.
3. Ztuc solution. Sulphate of zinc (white vitriol) 4 ounces, salt 2 ounces,
water 1 gallon.
4. Chloride of lime solution. Fresh chloride of lime 6 ounces, water 1
gallon.
44 NORTH CAROLINA BOARD OF HEALTH.
5. Milk of I'nne {irhneirash). Pour on 1 quart of quick-lime, broken into-small
ijieces, 1 quart of water. As soon as reduced to powder add 3-
quarts of water. Store in well-closed vessel. ^lake fresh supply every
few days, as it does not keep well. Can be kept much longer by pouring:
one-half cup of kerosene on top to exclude air.
(j. Sulphur finnlgation. The room must be vacated. Close as tightly
as possible every opening, fire-place by stutting tiiroat of chimney witli.
old bags or plenty of straw; cracks around doors and windows by calk-ing
with tow or cotton, etc. Place small lumps or powdered sulphur, in
the proportion of 3 pounds for every 1,000 cubic feet of air space to be-disinfected,
in an iron pot or pan free from cracks. Set the vessel, if it
has no legs, on bricks in the bottom of a tub containing 2 or 3 inches of
hot water (to put out fire in case burning sulphur should leak out or
overflow); light with red-hot coals or by pouring on a tablespoonful of
alcohol and applying a match. Be careful not to inhale the fumes. Close
the door of exit as tight as possible. Keep the room closed for twelve
hours, excei^t in cases where family has no other room to sleep, then,
six hours. Then open all doors and windows and air thoroughly.
NOTE.
It i.« practically established that if the instructions given in this circu-lar
ai'e faithfully carried out these justly dreaded diseases will not spreads
Such being the fact the responsibility of those whose duty it is to carry
them out is great.
A positive })romise from the attending physician to the County Super-intendent
of Health, or to the municipal medical health officer, to see
that the instructions are faithfully carried out would relieve the latter of
responsibility.
The Count}' Superintendent of Health or the municipal medical health
officer should not fail to promptly furnish to both the attending physi-cian
and the liouseholder in whose family either of the diseases men-tioned
in section 9 occurs a copy of these instructions.
Any further information desired will be cheerfully furnished.
RICH'D H. LEWIS, M. D.,
Secretary.
A copy of these instructions, together with a copy of
the new hiw, was mailed to every registered physician in
ever}^ county in North Carolina except four, from the
Clerks of which no reply has been received to either of mj-two
letters: I shall write them a^ain.* The total number
*The list of physicians has been made complete, and the instructions were promptly
distributed.
FIFTH BIKNNIAL KEPORT. 45-
mailed so far is 1,517. The "instructions" in quantity
will be sent to all County Superintendents and municipal
health officers. With them will be sent the placards
required to be posted on the front door of every house con-taining
a case of either of the diseases mentioned in sec-tion
nine.
Continuing the plan of trying to educate the people in
sanitary matters b}' popular articles in the newspapers, I
sent an article, together with a copy of the Instructions for
Quarantine and Disinfection, to every newspaper in the
State with a request that they publish same.
Just on this line members of the profession can be of
great assistance, provided they approve of the plan and
the articles, by using their influence with the editors of
their local papers to get them to publish them. A public
sentiment favorable to sanitation must be built up if we
expect to make any substantial progress. The Anglo-
Saxon people of this free country cannot be driven to the
performance of what they do not approve. They must be
persuaded of the importance of these restraints upon their
liberties under certain circumstances before they can be
successfully imposed.
But the physicians of the State can be of much greater-service
to the cause of the public health in another way,,
and that is by giving to the law and the sanitary regula-tions
imposed by it their own cordial support. Indeed
the practical application of the law is in the hands of our
medical men. If they give it their cordial support and
urge its importance upon their patients it will be carried
out, but if the}' are indifferent, and make light of and
belittle it it will surely be largely of no effect. In view of
the wholesale danger to life of the spread of contagious
and infectious diseases, which can almost surely be pre-vented
by the strict enforcement of .^anitary regulations,
46 NOIITH CAROLINA BOARD OF HEALTH.
this is no light responsihiUty wliich rests upon us, whether
Y\'o arc willino- to assume it or not.
kSeetion 1!) of tlio law requires all Htatc institutions
before adojiting a system of water supply and sewerage to
consult the State Board of Health. In compliance with
that requirement the President of the Board of Directors
of the proposed School for the Deaf and Dumb at Morgan-ton
addressed the following letter to the President of the
Board of Health :
BiLTMORE, N. C, March 31, 1893.
/);. Herirn T. B<(himm, Scilcin, X. <'.,
Dear Sir:—I see that the Laws of 1803 make it the dut_y of the Board
of Health of the State of North Carolina to consult and advise with all
the State institutions already having or intending to introduce systems
of water supply, drainage, or sewerage. The Board of the Deaf and
Dumb School at Morganton are considering their water supply; we are
considering two ways of furnishing same. One by gravitation, and to get
it would have to lay a line of pipe about four miles at a cost of from
$12,000 to $15,000, which is more money than the Board can pay if we
can get that which will answer clieaper. We also have under considera-tion
the "Gang Well'* system, which, if it is thought it will work well
and the quality of the watei- is all right, will be a great deal cheaper.
This system we will have ample means of testing, as the Morganton Tan-nery
is putting in a gang well on adjoining property to that of the insti-tution.
I do not think there will be a doubt as to quantity if the quality
is what is desired. T go into the details so you can the l)etter advise us,
and to do this would be glad to have you with us at our next Board
n^iCcting on the 14th April. The sewage from tb.e building will be con-ducted
in the usual sewage pipe one-half mile from building, emptying
into a creek with a fall of about one hundred and fifty feet.
Holding to hear from you on the subject, or, better, see you at our
meeting, I am very truly,
M. L. REID,
Chairinau Board Deaf and Dumb School.
In accordance therewith a committee composed of Drs.
H. T. Bahnson and S. Westray Battle visited Morganton,
examined carefully into the matter and made the follow-ing
report:
FIFTH lilKNXIAL KEPOET. 47
May o, 1893.
To till' Honorable Board of DlnctorK
Deaf and Dninh School at Morganton, X. <'.,
Gextlemex:—The committee appointed by the North Carolina Board
of Health, in compliance with your request, to examine and advise your
honoraVjle body relative to a water supplj- and sewerage system for the
Deaf and Dumb School at ^lorganton, N. C, beg to submit tlie following
report:
A careful inspection of the site and surroundings has satisfied us that
the sewage of the institution should be emptied directly into Hunting
creek. The smaller stream to the rear of the school is objectionable on
account of its limited water supply, and its liability to overflow during
freshets and deposit the sewage on the lowlands in its course. The preva-lent
westerly winds would thence convey its unpleasant and perhaps
noxious efHuvia to the institution. Hunting creek furnishes so large a
volume of water that this menace is enlirelj' avoided, and a conduit in
a direct line, with ample and uninterrupted fall, would cost very little
more.
The water supply presents a more difficult problem. Wiiile there is no
doubt in our minds that a pipe line from, a mountain stream, whose water
shed could be owned and protected by the authorities of the institution,
would furnish the best and safest supply, the great cost practically pro-hibits
its adoption. A system of gang wells has been successfully
employed by the large tannery on the adjoining property, which fur-nishes
very much more water than will ever be I'equired bj- your institu-tion.
This water is apparently pure and the plant required an outlay of
less than one-fourth of the amount whicli a pipe line from the mountain
would cost.
The site in the rear of the school is apparently favorable for the adop-tion
of a similar system. "Water ol)tained here would probably be free
from mineral impurity, and the danger of contamination is so remote
that it can safely be left out of consideration.
Under the circumstances we cannot hesitate to recommend tliat an
attempt be made to obtain a water sujiply from this source.
Very respectfully,
HENRY T. BAHNSOX, M. D.,
8. WESTRAY BATTLE, M. D.,
Committee.
It needs no argument to prove that the greatest danger
from contagious and infectious diseases is where numbers
of people are congregated together in close quarters, and
therefore that the machinery for combating them should be
48 NORTH CAROLINA JJOAIID OF H1:ALTH.
made as near perfect as possible in tlie cities and towns.
To that end the organization of local municipal Boards of
Health is a necessity. Section 25 of the law confers full
powers upon all municipal corporations to make such
regulations and impose such penalties for tlic preservation
of the public health as thev mav deem necessary ; but the
matter is always optional with them. In the hope of
inducing as many as possible to organize Boards of Health
with the necessary powers, I have prepared the following
letter to be sent to the Mayors of all towns of more than
500 inhabitants:
R.VLEiGH, X. C, May 8, 1893.
Sis Honor Ihe Muyor,
De.\r Sir:—The warm weather is upon us and it is time for those of
us upon M'hom rests the responsibility of looking out for the protection
of the health of the people to be bestirring ourselves. ^Yhenever there
is a Board of Health organized it is clearly its duty; but otherwise, in
cities and towns, it falls upon the Mayor and Board of Aldermen or
Town Commissioners. It is best, however, to have a body whose special
duty it is, and therefore it is expressl}' desirable that Boards of Health
should be formed in all towns where they do not already exist. This is
particularly the case just at this time, since the entrance of cholera into
our countiy this summer is regarded as more than probable.
Have you a Board of Health in your town? If so, will you be kind
enough to send in the names of its ofhcers and a copy of its sanitary
regulations? If not, will you not exert yourself to secure the form-ation
of one as soon as possible? If desired, I would take pleasure
in forwarding to you, free of charge, model ordinances, blanks, etc.
Your aid in this important matter is asked in the interest of your own
people, chiefly, but also for the sake of other citizens of the State who
might incur disease from your town if the proper and necessary sanitary
precautions are neglected.
Your kind attention will oblige.
Yours very respectfully,
RICH'D H. LEWIS, M. D.,
Secretary.
The subjoined letter, inclosing model ordinance, blanks,
etc., was sent to every county-seat and other town of more
than live hundred inhabitants:
FIFTH lilKXXIAL KKPORT. 49
Raleigh, X. ('., June 0, 1S93.
77/1' IIiiiKirdhIr Miiijor mid Fxntrd of ,
(tentlemex:—I send herewith a copy of the Act Relating to the Board
of tloalth (Chai)ter 214, Laws of 1893), a model health ordinance, based
chieHy on the admirable one issued by the Pennsylvania P.oard of
Health, and various blanks which explain themselves. I hope that you
will adopt and enforce them, thereby materially advancing the cause of
l)nblic health and pan jkihsu the i:>rosperity of your town. The ordi-dance
may strike you as being rather voluminous, but a careful consid-eration
of the same will, I think, show the reasonableness and impor-tance
of each section. Still, if deemed necessary, it can be modified to
suit the particular conditions of your town, though I would be glad to
have it adopted as it stands in order to secure a uniform system in every
town in the State.
In cities and towns where people are more or less crowded together,
and the danger of contamination of air and drinking water and of the
spread of communicable diseases from person to person is in consequence
greatly increased, the practical application of sanitary laws is especially
important. The collection of vital statistics, particularly those relating
to the cause of death, should be carefully looked to in order to ascertain
those most prevalent, with a view to taking special precautions against
them in the future. It is also of great importance from a material point
of view. One of the liist inquiries made by intending immigrants is in
regard to the healthfulness of tiieir contemplated destination, and that
information would be sought for at this office. To give an opinion I
must be assured of their coiiiplcteuess and accuracy. Those two essentials
cannot be obtained unless the method recommended is faithfully carried
out, viz., the positive refusal to allow the body of any one dying in the
town to be buried or removed without a permit from a designated
official, based upon a properly tilled out and signed death certificate
giving the cause of death; or some other method e(}ually as reliable.
The healthfuhiess of our State is one of its greatest attractions, and the
only way to demonstrate it to strangers in these days of scientific
accuracy is by means of reliable vital statistics. In our present stage of
sanitary development these statistics can only be obtained from our
cities and towns, and I trust y(ju will help your own immediate home
and, at the same time, aid me in show'ing to the world our advantages
in this most important item of health.
Any further assistance in my power would be most gladly rendered l.-y.
Yours very respectfully,
RIGHT) H. LEWIS, SI. I).,
Sccrettiri/.
'~>0 NORTH CAROIJXA P.OARD OF HEALTH.
ORDINANCE OF THE OF
FOR THE BETTER PRESERVATION OF THE PUBLIC HEALTH
AND TO PREVENT THE SPREAD OF C0M:\IUNICABLE DIS-EASES.
In virtue of the powers conferred by section 25, chapter 214, Laws of
1893 of the State of Nortii Carolina, be it ordained by the-of
thet ----of --,anditis hereby ordered by the
authority of the same
—
Section' 1. That the Mayori shall constitute a Local
Board of Health for thet of , whose duty
it shall be to faithfully execute all Laws of the State (chapter 214, Laws
of 1893—An Act Relating to the Board of Health) and all ordinances
relating to the public health of thef of The
Board of Health shall have power to make all necessary rules and regu-lations
for the promotion and preservation of the public health and the
collection and registration of vital statistics within thet
of --.subject to the ratification of the* A
majority of the members shall constitute a quorum.
Sec. 2. The ]\Iayor shall be ex officio President of the Board of Health.
Heshall convene the Board in regular session on the first*]^
in each month from April to Octol^er inclusive, and quarterly thereafter,
and shall have power to call the said Board together in extra session
whenever, in his judgment or in that of the health officer, the public
health demands it.
Sec. 3. The medical member| of the Board shall be e.v officio the health
officer of thet , and shall be the executive officer of the
*Insert City Couucil, Board of .-Vldermen or Board of Town Conunissiouers, as the
•case may be.
tCity or Towu.
'^Foi- small lo7c!is insert '"the Town Clerk and the County Superintendent of Health "
{if that official is a resident of the town and acceptable to the town authorities), otherw^ise
insert "the Town Clerk and a resident registered physician to be elected bj- the Board
of Towu Comiuissioners."
F'or larger tozvns insert " the Towu Clerk and three resident registered physicians to
be elected by the Board of Town Coniinissioners.'' If preferred insert "the Town Clerk
and three other persons, one of whom shall be a resident registered physician to be
elected, etc."
For cities insert " Chief of Police, City ,\ttornej-. Chairman of the Sewer Committee.
Chairman of the Water Committee, Chairman of the Street Committee and County
Superintendent of Health" (if he be a resident of the city), otherwise " a resident regis-tered
physician to be elected by the Board of Aldermeu." Perhaps it might be better
to insert after City Attorney "the County Superintendent of Health and three other
resident registered physicians to be elected by the Board of .\ldermen."
•"Insert day of week.
5\Vhere there is more than one medical member of the Board substitute " The medi-cal
member of the Board receiving the highest number of votes shall be the health
officer."
FIFTH niKXXIAr. i;Er(*RT. ol
Board. He shall perform for the* the duties^ of the County
Superintendent of Health as laid down in Chapter 214, l^awsof 189o, and
such other duties as may be imposed by the Board, including the collec-tion
of vital statistics, which he shall use every effort to make as full and
accurate as possible, especially such as relate to the cause of death. He
shall notify the Secretary of the State Board of Health of his election
and shall make such reports and answer such inquiries concerning the
sanitary condition of thef , diseases prevalent, vital statistics,
etc., as may be required by the State Board of Health. He shall hold
his office for years, and until his successor is appointed
and has qualified.
Sec. 4. The* Clerk shall be ex officio Secretary of the Board.
He shall keep a full and accurate record of all business done at its meet-ings.
He shall cause to be published in the newspapers of the*
and by printed or written notices, to be posted inf , all orders,
rules and regulations of the Board, which pablication shall be deemed
legal notice of the same to all persons. He shall file and keep for refer-ence
all reports, complaints, orders or other papers relating to the busi-ness
of the Board. He shall also keep, in a book provided for the pur-pose,
a full and complete record in detail of all vital statistics.
Sec. 5. The Board of Health may, with the approval and consent of
the Board of J electa speciaHj , or use one
of the regular force, who shall be known as the Sanitary Inspector. He
shall inspect at least once in every month, from April to October inclu-sive,
the premises of every householder in the "^ He shall
make a note of and report in writing to the health officer any violations
of the orders, rules and regulations promulgated by the Board, and shall
serve such legal notices as the Board may direct. His term of office and
compensation shall be fixed by the Board ofi
Sec. 6. The Board of Health, through its health officer, shall make a
report annually in ]March, for the preceding twelve months ending with
the last day of February, to tiie Board of j
Sec. 7. Whatever is dangerous to human life or health, whatever ren-ders
the air or food or water or other drink unwholesome, and whatever
building, erection, or part or cellar thereof, is overcrowded or not pro-vided
with adequate means of ingress and egress, or is not sufficiently
supported, ventilated, drained, cleaned or lighted, are declared to be
nuisances, and to be illegal; and every person having aided in creating
or contributing to the same, or who may support, continue or retain any
of them, shall be deemed guilty of a violation of this ordinance, and
also be liable for the expense of the abatement and i-emed\' therefor.
*City or Town, flnsert number and location of public places.
|Town Commissioners or Aldermen. IConstable or policeman.
52 NUUTH CAROLINA Bt)AKL) OF HEALTH.
Skc. 8. No house-refuse, oft'al, garbage, dead animals, decaying vegeta-ble
matter or organic waste substance of any kind shall l)e thrown on
any street, road, ditch, gutter or public place within the limits of this
. , and no putrid or decaying animal or vegetable matter shall
beTkept in any house, cellar or adjoining out-]»uilding or grounds for
more than twenty-four hours.
Sec. it. No person or persons without the consent of the Board of
Health"" shall build or use any slaughter-house within the limits of this
, and the keeping and slaughtering of all cattle, sheep and
swine and the preparation and keeping of all meat, tish, birds, or other
animal food, shall be in the manner best adapted to secure and continue
their healthfulness as food; and the keeping of the premises shall be
with such care and cleanliness as not to endanger the public health. No
meat, fish, birds, fowls, fruit, vegetables, milk, and nothing for human
food not being then healthy, fresh, sound, wholesome, tit and safe for
such use, nor any animal or'fish that died by disease or accident, and
no carcass of any calf, pig or lamb which at the time of its death was
less than four weeks old, and no meat therefrom, shall be brought within
the limits of this , or offered or held for sale as food any-where
in said
Sec. 10. No person or company shall erect or maintain within the
limits of this— any manufactory or place of business danger-ous
to life or detrimental to health, or where unwholesome, ofiensive or
deleterioiis odors, gas, smoke, deposit or exhalations are generated, such
as tanneries, refineries, manufactories of starch, glue, leather, chemicals,
fertilizers, gas, etc., without the pernjit of the Board of Health,* and all
such establishments shall be kept clean and wholesome so as not to be
offensive or prejudicial to public health.
Sec. 11. The keeper or keepers of a livery or other stable shall keep
liis or their stable-j-ard clean, and shall not permit, between the first day
of April and the first day of Novembei", more than loads of
manure to accumulate in or near the same at any one time except by
express permission of the Board of Health.*
Sec 12. No pig-pen shall be built or maintained within the limits of
this without a permit from the Board of Health,* or
within one hundred feet of any well or spring of water used for drinking
purposes, or within thirty feet of any street or of any inhabited house,
or unless constructed in the following manner, viz., so that the floor of
the same shall be not less than two feet from the ground in order that
the filth accumulating under the same may be easily removed; and such
filth accumulating in, about and under the same shall he removed at
*Where there is no Board of Health organized snbstitute " Board of Town Commis-sioners
" or " Board of Aldermen.''
FIFTH i'.TKXXIAL REPORT. 53
least once a Aveek, and oftener if so ordered, and on the fiulure of any
owner or occupier of such premise;^ i^o to do, then the same sliall be
done by the
Sec. lo. Xo privy-vault, cess-pool or reservoir, into which a privy,
water-closet, cess-pool or stable or sink is drained, shall be consti-ucted,
dug or permitted to remain within the corporate lin)its of this
Earth privies and earth closets, witli no vault, pit or depression below
the surface of the ground, are allowed, but sufficient dry earth or ashes
must Vje used daily to absorb all the fluid part of the deposit, and the
contents must be completely removed at least once every month. •-
Sec. 14. The following diseases are declared to be communicable and
dangerous to the public health, viz.: small-pox (variola, varioloid),
cholera (Asiatic or epidemic), scarlet fever, (scarlatina, scarlet rash),
measles, diphtheria (diplitheritic croup, diphtheritic sore throat), typhoid
fever, typhus fever, yellow fever, spotted fever (cerebro-spinal meningitis),
epidemic dysentery, hydrophobia (rabies) and glanders (farcy), and shall
])e understood to be included in th.e following regulations, unless certain
of them only are specified.
Sec. 15. Whenever any householder knows that any person within
his family or household has a communicable disease, dangerous to the
public health, he shall, within twenty-four hours, report the same
to the health otficer,t giving the street and numl)er or location of the
house.
Sec. 1(i. Whenever any jihysician finds that any person whom he is
called upon to visit has a communicable disease, dangerous to the public
health, he shall, within twenty-four hours, report the same to the health
officer,t giving the street and number or location of the house, on the
receipt of which report the health officer shall immediately notify the
school committee of the public school, the superintendent of the
graded school and the principals of private schools within the limits of
this , at the same time calling their attention to Section
13, Chapter 214, Laws of 1893.
Sec. 17. No person shall, within the limits of this , unless
by permit of the health oflEicer,j carry or remove from one building to
another any patient atFected with any communicable disease dangerous
to the public health. Nor shall any person, by any exposure of any
individual so afiected, or of the bodv of such individual, or of any
*To towns and cities having- already or about to introduce a system of sewerage sug-gestions
as to the proper ordinances will be gladly furnished by the Secretary of the
State Board of Health.
fWhere there is no medical health officer insert "County Superintendent of Health."
as required by chapter 214, Laws of 1S93.
tWhere there is no Board of Health insert "County Superintendent of Health."
54 NOKTH CAROLINA BOARD OF HEALTH.
article capable of conveying contagion or infection, or by any negligent
act connected with the care or custody thereof, or by a needless expo-sure
of himself or herself, cause or contribute to the spread of disease
from any such individual or dead body.
vSec. 18. There shall not be a public or church funeral of any person
who has died of Asiatic cholera, small-pox, typhus fever, diphtheria,
yellow fever, scarlet fever or measles, within the limits of this
and the family of the deceased shall in all such cases limit the attend-ance
to as few as possible, and take all precautions possible to prevent
the exposure of other persons to contagion or infection; and the person
authorizing the public notice of death of such person shall have the
name of the disease which caused the death appear in such public
notice.
Sec. 19. Xo person shall let or hii'e any house, or room in a house, in
which a communicable disease, dangerous to the public health, has re-cently
existed, until the room or house and premises therewith con-nected
have been disinfected to the satisfaction of the Board of Health,'^
in accordance with the "Instructions for Quarantine and Disinfection"
furnished by the Secretary of the State Board of Health; and for the
purposes of this section the keeper of a hotel, inn, or other house for
the reception of lodgers, shall be deemed to let or hire part of a house
to any person admitted as a guest into such hotel, inn or house.
Sec 20. Members of any household in which small-pox, diphtheria,
scarlet fever or measles exists shall abstain from attending places of pub-lic
amusement, worship or education, and fiom visiting other private
houses except on express permission of the health officer.*
Sec. 21. The clothing, bed-clothing and bedding of persons who have
been sick with any communicable disease, dangerous to the public health,
and the articles which they have used and the rooms which they have
occupied during such sickness shall be disinfected under the direction
of the Board of Health* in accordance with the "Instructions for Quar-antine
and Disinfection" furnished by the Secretary of tlie State Board
of Health.
Sec. 22. Upon the appearance of a case of small-pox inf
county it shall be the duty of every adult and every parent, guardian or
master of every minor residing within the limits of thisi ,
who has not had small-pox or been vaccinated so as to have taken cow-pox
regularly, to be, if an adult, vaccinated, or in the case of a minor,
to cause such minor to be vaccinated within two weeks after the appear-
*Where there is no Board of Health insert "County Superintendent of Health."
tlnsert name of county in which town or city is situated, or if preferred substitute
"within a radius of miles."
JCity or town.
FIFTH BIENNIAL REPORT. 55
ance of such case of small-pox unless unable to do so \)y reason of pov-erty;
and it shall be lawful for any registered physician residing in this*
, on application of such resident adult, or parent, mas-ter
or guardian of such resident minor, as is unable by reason of poverty
to pay the vaccination fee, to vaccinate said adult or said minor and
present his bill therefor, properly authenticated, for an amount not
exceeding the fee iisually charged for such services, and to recover the
same of and from the corporation, f
Sec. 23. Every undertaker or other person who may have charge of
the funeral of any dead person shall procure a properly filled out cer-tificate
of the death and its probable cause, in accordance with the form
prescribed by the State Board of Health (no other to be valid), and shall
present the same to the designated otlicer or member of the local Board
of Health and obtain a burial or transit permit thereupon at least twenty-four
hours before the time appointed for such funeral or removal; and
neither lie nor an}- other person shall remove any dead body until such
burial or transit permit shall have been procured.
Sec. 24. Every person undertaking preparations for the burial of a body
dead from communicable disease as hereinbefore enumerated shall adopt
such precautions as are set forth in the "Instructions for Quarantine and
Disinfection," furnished by the State Board of Health, to prevent the
spread of such disease.
Sec. 25. Every physician or midwife attending or present at the l)irih
of any human being within the shall, wdthin twenty-four hours
thereafter, certify the same to the health officerj upon blanks prescribed
by the State Board of Health to be furnished by said health officer. In
case there be no attending physician or midwife, then the next of kin or
other person present at such birth shall, within twenty-four hours there-after,
report the same to the health officer, who shall then have the
proper blank filled out.
Sec. 26. All physicians, midwives and undertakers practicing or doing
business in this shall register their names and addresses with
the Secretary of the Board of HealthlT within thirty daj-s after the pro-mulgation
of this ordinance; and hereafter within ten days after begin-ning
practice or business.
Sec. 27. Such pertinent portions of chapter 214, Laws of 189o, as are
not included in the above sections are hereby adopted as a part of this
ordinance.
Sec. 28. Every person violating any section of this ordinance shall be
liable for every such offense, upon conviction before the mayor or other
*City or town.
flf preferred the vaccination of paupers might be required of the health officer,
where there is one. the town furni.shin.s: the virus, or the fee might be fixed in advance
by agreement with the physicians. The vaccination of tlie people is of tlie highest
importance and everj' effort should be made to accomplish it. The amount of raw-material
ready to be worked up by small-pox in this State is simply appalling.
JWhere there is no health officer substitute " Citv or Town Clerk.''
IJWhere there is no Board of Health substitute "City or Town Clerk."
4
56 NORTH CAROLINA BOARD OF HEALTH.
justice of the peace, to a fine of not less than S."5 nor more than $25, or
imprisonment for not more than ten days, at the discretion of the con-victing
justice, besides costs, which he may inflict in addition if he see fit.
BIRTH CERTIFICATE.
N. C, ISO-Date
of Birth
Name of Child, if named
Name of Father
Name of Mother
Residence, No Street Ward
Color Sex ^
Condition of Child
Attendin'g» Physician or Midwife
CERTIFICATE OF DEATH AND APPLICATION FOR BURIAL
OR TRANSIT PERMIT.
To the* of N. C:
Date of Death
Full Name of Deceased!
Sex, Male or Female
Age Years Months Days.
Color
Married, Single, Widow' or Widower
Occupation
Birthplace
Place of Death, No. , Street, Ward.
Cause of Death
Duration of Last Sickness
Place of Burial -_ ^
Date of Burial I M. D.,
f Undertaker f Medical Attendant.
\ Place of Business j %
Personally appeared before me on this the day of 189--
and made oath that the above statement
in regard to the death of is true.
,J. P.
*This certificate must be returned to the official selected for the purpose—Town Clerk,
Chief of Police or some other— for Burial Permit.
tif still-born, give names of parents on this line.
jlu case there was no medical attendant, this certificate may be signed by the Health
Officer, after careful inquirj' as to the facts required to be noted. Or it ma3' be signed
on oath before a Justice of the Peace by the householder in whose house the death
occurred, or by the next friend of the deceased who was present. Where there was an
attending physician no other signature than his should be accepted.
Note.—The apparent amount of " red tape" in this certificate in the matter of requir-ing
the householder or next friend to make oath before a Justice of the Peace is ren-dered
necessary by the fact that death certificates are often used in the courts as evi-dence,
and the disposition of large sums of money may depend upon their accuracy and
reliability.
L'lFTH BIENNIAL REPORT. 57
nj
so oO
o
•-^
W
p
^ G
58 NORTH CAROLINA BOARD OF HEALTH.
FORM FOR SAXITARY INSPECTION OF CITIES AND TOWNS.
1. Inspection-books are furnished as per Form No. 1.
2. The Inspector is presumed to have received intelligent drilling from
the Health Officer in the many features of unsanitariness which will be
met with, and is moreover, presumed to be a person of good judgment
and discretion, and to have a high standard of sanitary methods, with
his heart in the work.
3. The inspection districts having been designated by the Board, the
Inspector begins work at a set point and makes an entire inspection of
the district house by house, block by block, noting down the conditions
in Inspection-book as provided under manner of Form No. 2.
4. Should any bad features exist the Inspector is to point out to the
householder where the remedy can be applied and the necessity for it,
and to leave upon the premises the notice of Form No. ;]. Should the
existing conditions be not really bad, but clearly not good, the Inspector
is required to inform the householder where the defect lies, and to urge
upon liim the benefits resulting from thorough cleanliness.
5. After each inspection district has been gone over Inspector should
make a report to the Health Officer or Mayor of total inspections and
their results upon Form No. 4: this to be kept on file by the Secretary
of Board for future comparisons.
6. A space of nine lines should be given to each lot in order that the
record of the whole number of inspections made during the year
(monthly from April to October, inclusive, and quarterly thereafter)
may be arranged for easy comparison. The Inspector should not only
call attention to violations of the sanitary rules and regulations and
note bad conditions, but he should make it a point to encourage those
who are evidently trying to do their sanitary duty.
7. At stated intervals a notice should be given through the public
press of what the comparative results show, thereby enlisting an interest
in the work from those who might not be reached bv other means.
Although modified by myself in some respects, the credit for these forms is due to
Mr. Alfred V. Wood. Secretary of the Board of Health of Brunswick, Ga., a brother of
our late deepU' lamented Secretarj-, and a sanitary expert.
FIFTH BIENNIAL REPORT. 59
Form No. i.
SAMPLE PAGE OF INSPECTION BOOK.
1893-'94.
April
May
June
July
Aug.
Sept.
Oct.
Jan.
April
May
June
124 Wolf Street,
(I
1 T. PI. Jones,
And so on down.
1
60 NORTH CAROLINA BOARD OF HEALTH.
To be sent on the first day of each mouth for the mouth preceding to the Health
Officer or Alayor.
Form No. 4.
SAXITARY INSPECTION DISTRICT No
Month of 189-
FIFTH BIENNIAL REPORT. 61
known to carry contagion. He invited members of the
Society to visit the Station after its completion and see it in
operation.
Dr. Reagan deprecated the lack of interest on the part of
members in the Conjoint Session, and thought this lethargy
must be overcome before we can expect to excite the interest
of the legislators and the laity.
Dr. H. W. Lewis said it would take the stimulus of an
epidemic to create an interest in sanitary matters among the
physicians of his county. In making his reports as Superin-tendent
of Health he had to depend almost entirely upon
his own practice in enumerating the prevailing diseases.
He thought the law, while probably as good as could be
obtained, was defective in not making provision for the
remuneration of Superintendents for their extra and especial
services in case of epidemics. He understood the law to
only give the Superintendent the right to charge for his
visits to the poor-house and jail. (The Secretary explained
that it gave him the right to demand the fees usual in his
count}' for any services he might render). He regretted
there had been no legislation in regard to vaccination. His
county was raising a large crop for the Reaper should an
epidemic of sraall-pox appear.
The Secretary stated that in regard to vaccination tlie
Conference were in accord as to the desirability of com-pulsory
vaccination, but that such a clause in the bill would
have jeopardized the whole bill. People cannot be driven
in these matters. In this connection he referred to some
remarks made by Dr. Lewis at the last meeting, when he
stated that he had appointed a day on which to vaccinate
the pupils at a county school, and when he arrived there
he found that all the school had taken flight.
The Secretary announced that the terms of office of him-self
and Dr. Bahnson expired with this meeting, and that
62 NORTH CAROLINA BOARD OF HEALTH.
imder the new law these vacancies would be filled by the
Governor's appointment.
There was some discussion as to whether it would be
proper for the Society to recommend candidates for appoint-ment,
but it was the sense of the meeting that it should be
left for the Governor to ask for such recommendation should
he desire it.
The Secretary called the attention of Superintendents of
Health to the fact that it is now made obligatory on him to
notify the County^ Commissioners of the failure on the part
of the Superintendents to make their reports. He also
urged upon physicians to attend the meetings of the Board
of Health for the election of Superintendents that proper
men may be selected for these positions.
On motion the Conjoint Session adjourned.
RICH'D H. LEWIS, M. D.,
Secretary.
CONJOINT SESSION AT GREENSBORO, MAY 15, 1894.
At 12 M. the Board met in conjoint session with the
State Medical Society, President Bahnson in the chair.
Passed Assistant Surgeon Jos. J. Kinvoun, of the United
States Marine Hospital Service, having accepted an invita-tion
of the President of the Board to attend the meeting, was
upon motion invited to a seat upon the floor and to partici-pate
in the discussions. He acknowdedged the courtesy in
an appropriate manner.
The Secretary then read his annual repoi't as follows:
FIFTH lUKXXIAL REPORT. 03
ANNUAL REPORT OF THE SECRETARY OF THE
NORTH CAROLINA BOARD OF HEALTH.
By Richard H. Lewis, M. D., Raleigh, N. C.
AVhen your Secretary made his last annual report the
sanitary sky to the eastward was overcast with the dark
and lurid clouds of cholera. There was in the minds of
people at large to some extent, hut more especially of those
whose duty it was to stand as sentries upon the watch-towers,
a feeling of apprehension lest these threatening
clouds should reach our shores and deluge us with the
dreaded pestilence.
Later yellow fever appeared at Brunswick, Ga., almost
at our doors, and our health officers ou our seaboard,
particularly at our port of Wilmington, had their anxieties
greatly increased. Still later small-pox began to spread
over the country and is not 3'et, we regret to admit,
stamped out.
Notwithstanding these valid grounds for uneasiness our
fears have not been realized. "We have to felicitate our-selves
and the people of our State and generally of our
whole country upon their escape. And in doing so we
should make our acknowledgments to the United States
Marine Hospital Service for its excellent management in
keeping cholera (except one case at Jerse}'' City) out of our
country and in practically bottling up the yellow fever at
and near Brunswick.
In making this report your Secretary does not

FIFTH BIENNIAL REPORT
OP THE
NORTH CAROLINA
BOARD OF HEALTH,
1893-1894.
Cfte Library
of tipe
llniumt^ of Jl^ottb Carolina
ki ^5-t.
/f-/ -b
FIFTH BIENNIAL REPORT
t
OF THE
NORTH CAROLINA
BOARD or HEALTH,
1893-1894.
RALEIGH:
JosEPHus Daniels, State Printer and Binder.
PRESSES OF E. M. UZZELL.
1895.
2.^970-
MEMBERS OF THE BOARD
ELECTED BY THE MEDICAL SOCIETY OF THE STATE OF
NORTH CAROLINA.
George GillETT Thomas, M. D., President: Wilniiugtou.
Term Expires iSgy.
S. Westray Battle, M. D Asheville.
Term Expires 1897.
W. H. Harrele, M. D Williamstou.
Term Expires 1S95.
John Whitehead, M. D Salisbury.
Term EJxpires 1S95.
APPOINTED BY THE GOVERNOR.
W. H. G. Lucas, M. D White Hall.
Term Expires 1895.
W. P. Beael, M. D Greensboro.
Term Expires 1S95.
F. P. Venable, Ph. D., F. C. S Chapel Hill.
Term Expires 1S95.
John C. Chase, Sauitar}' Engineer Wilmington.
Terni Expires 1895.
Richard H. Lewis, M. D., Secretary Raleigh.
Term Expires 1895.
STANDING COMMITTEES.
Epidemics—Drs. Lewis and Whitehead.
Water Supply and Drainage—Dr. Thomas and Mr. Chase.
Hygienics of Public Schools—Drs. Whitehead and Lucas.
Climatology—Dr. S. W.' Battle.
Adulteration of Food and Medicines—Prof. F. P. Venable.
Sanitary Condition of State Institutions—Drs. Harrell and Beall.
Vital Statistics—Drs. Lewis, Thomas and Harrell.
LIST OF COUNTY SUPERINTENDENTS OF HEALTH IN THE
STATE OF NORTH CAROLINA, DECEMBER 31, 1894.
Alamance—Dr. R. A. Freeniau, Burliugton.
Alexander—Dr. R. B. Killiau, Taylorsville.
Alleghany—Dr. C. G. Fowlkes, Topia.
Anson—Dr. E. S. Ashe, Wadesboro.
Ashe—Dr. L. C. Gentr}-, Jefferson.
Be.aUFORT—Dr. John C. Rodman, Washington.
Bertie—Dr. H. V. Dunstau, Windsor.
Bladen—Dr. Newton RoVjinson, Elizabethtown.
Brunswick—Dr. D. I. Watson, Southport.
Buncombe—Dr. H. L. Baird, Asheville.
Burke—Dr. J. L. Laxton, Morgantou.
Cabarrus—Dr. Leona M. Archey, Concord.
Caldwell—Dr. A. A. Kent, Lenoir.
Camden—
Carteret—Dr. George N. Ennett, Beaufort.
Caswell—Dr. W. O. Spencer, Yanceyville.
Catawba—Dr. J. M. McCorkle, Newton.
Ch.atham—Dr. L. A. Hanks, Pittsboro.
Cherokee—Dr. J. F. Abemathy, Rlurphy.
Chowan—Dr. R. A. Winborne, Barnitz.
Clay—Dr. W. E. Sanderson, Hayesville.
Cleveland—Dr. O. P. Gardner, Shelby.
Columbus—Dr. I. Jackson, Wliiteville.
Craven—Dr. Leinster Duffy, Newliern.
Cumberland—Dr. J. H. Marsh, Fayetteville.
Currituck—
Dare—Dr. W. H. Peterson, Mauteo.
Davidson—Dr. R. L. Payne, Jr., Lexington.
Davie—Dr. James McGuire, Mocksville.
Duplin—Dr. W. P. Kennedy, W'arsaw.
Durham—Dr. John M. Manning, Durham.
Edgecombe—Dr. Donald Williams, Tarboro.
Forsyth—Dr. D. N. Dalton, Winston.
Franklin—Dr. E. S. Foster, Louisburg.
Gaston—Dr. J. H. Jenkins, Dallas.
Gates—Dr. I W. Costen, Gatesville.
Graham—
Granville—Dr. W. O. Baskerville, Oxford.
Greene—Dr. E. H. Sugg, Snow Hill.
Guilford—Dr. A. R. Wilson, Greensboro.
4 LIST OF SUPERINTENDENTS OF HEALTH.
Halifax—Dr. I. E. Greeu, Weldoii.
Harnett—Dr. J. F. McKay, Dickiusou.
Haywood—Dr. J. Howell Way, Waynesville.
Henderson-Dr. J. L. Egertou, Heudersouville.
Hertford—Dr. John W. Tayloe, Union.
Hyde-
Iredell—Dr. W. J. Hill, Statesville.
Jackson—Dr. W. F. Tompkins, Webster.
Johnston—Dr. R. J. Noble, Selma.
Jones—Dr. R. A. Whitaker, Trenton.
Lenoir—Dr. C. B. Woodley, Kioston.
Lincoln—Dr. W. L. Crouse, Lincolnton.
Macon—Dr. S. H. Lyle, Franklin.
Madison—Dr. James K. Hardwicke, Marshall.
Martin—Dr. W. H. Harrell, Williamston.
McDowell—Dr. B. A. Cheek, Marion.
Mecklenburg—Dr. H. INI. Wilder, Charlotte.
Mitchell—Dr C. E. vSmith, Bakersville.
Montgomery—Dr. W. A. Simmons, Troy.
Moore—Dr. Gilbert McLeod, Carthage.
Nash—Dr. J. J. Mann, Nashville.
New Hanover—Dr. R. D. Jewett, Wilmington.
Northampton—Dr. H. W. Lewis, Jackson.
Onslow—Dr. E. L. Cox, Jacksonville.
Orange—Dr. C. D. Jones, Hillsboro.
Pamlico—
Pasquotank—Dr. W. W. Griggs, Elizabeth City.
Pender—Dr. George F. Lucas, Carrie.
Perquimans-Dr. John F. Speight, Hertford.
Person—Dr. C. G. Nichols, Roxboro.
Pitt—Dr. W. H. Bagwell, Greenville.
Polk—Dr. O. S. Missildine, Tryon.
Randolph—Dr. J. M. Boyette, Ashboro.
Richmond—Dr. J. M. Covington, Rockingham.
Robeson—Dr. T. A. Norment, Jr., Lumbertou.
Rockingham—Dr. D. W. Courts, Reidsville.
Rowan—Dr. John Whitehead, Salisbury.
Rutherford—Dr. W. A. Thompson, Rutherfordton.
Sampson—Dr. John A. Stevens, Clinton.
Stanly—Dr. D. P. Whitley, Millingport.
Stokes—Dr. W. L. McCanless, Danbury.
Surry—Dr. J. B. Hollingsworth, :Mt. Airy.
Swain—Dr. R. L. Davis, Bryson City.
Transylvania—Dr. C. W. Hunt, Brevard.
LIST OF SUPERINTENDENTS OF HEALTH. 5
TyrreI/L—Dr. Ab. Alexander, Columbia.
Union—Dr. J. K. Ashcraft, Monroe.
V.\NCE— Dr. W. T. Cheatham, Henderson.
Wake—Dr. P. E. Hiues, Raleigh.
Warren—Dr. P. J. Macon, Warrenton.
Washington—
Watauga—Dr. W. B. Councill, Boone.
Wayne—Dr. W. J. Jones, Jr., Goldsboro.
Wilkes—Dr. J. W. White, Wilkesl)oro.
Wilson—Dr. Albert Anderson, Wilson.
Yadkin—Dr. T. R. Harding, Yadkiiiville.
Yancey—Dr. J. L. Ra3-, Bnrnsville.
LETTER OF TRANSMISSION.
North Carolina Board of Health,
Office of the Secretary,
Raleigh, N. C, January 4, 1895.
His Excellency^ Elias Carr,
Governor of North Carolina^
Sir:—In accordance with Section 3, Chapter 214, Laws
of 1893, I have the honor to present this the Fifth Biennial
Report of the North Carolina Board of Health.
With great respect,
Yonr obedient servant,
RICHARD H. LEWIS, M. D.,
Secretary and Treasurer.
FIFTH BIE:NNIAL REPORT
OP THE
NORTH CAROLINA BOARD OF HEALTH.
1893=1894.
lu the two years that have elapsed since our last re[)ort
the cause of public hygiene iii our State has been markedly ,
advanced. The interest in this most important subject,
both on the part of members of the medical profession and
of the people generally, shows a very decided increase.
While our work has been, and continues to be, largely
"missionary" in character—to carry to those ignorant of,
or indifferent to, its saving power the gospel of health
—
the Board has accomplished much positive good. We feel
that we can claim without hesitation that the saving of
many valuable lives and the prevention of a large amount
of sickness can be directly traced to its efforts. The pro-visions
of the law enacted by the last General Assembly
requiring physicians to report immediately to the proper
health officer cases of contagious and infectious disease and
making it obligatory upon said health officer to see that
such diseases "are properly quarantined and isolated within
twenty-four hours after the case is brought to his knowl-edge,
and that after the death or recovery or removal of a
person sick of either of the diseases mentioned the rooms
occupied and the articles used by the patient are thoroughly
disinfected in the manner set forth in the printed instruc-tions,
both as to quarantine and disinfection, which shall
be furnished him by the Secretar}^ of the State Board of
8 NORTH CAROLINA BOARD OF HEALTH.
Health," have alone saved a loss to the State in dollars and
cents, considering death and sickness in terms of money,
far more than has been expended upon the Board from its
establishment. Unfortunately the evidence in support of
sanitarv science is necessarilv nee:ative in character. Its
function is not to cure disease and thus to positively save
from death, Ijut to prevent the inauguration of disease in
the first instance and thus to save the well from both sick-ness
and death which in many instances would have surely
come to them but for the effective precautions of the health
officer. There are many other excellent features in the
new law bearing upon the protection of school children
from disease, upon the drinking waters of the State, regu-lating
common carriers, and others, for a consideration of
which we would refer the reader to the law itself which he
will find in another part of this report.
As a result of the marvelous advance in bacteriology a
great discovery has been made in "antitoxine," which is
regarded as a sure preventive of, and when used soon
enough almost a sure cure for, diphtheria, the very name
of which strikes terror to a parent's heart. The infec-tiousness
of consumption is no longer disputed and know-ing
the cause, it can often be prevented by resorting to
suitable precautions. With more knowledge we hope to do
better work, and in the next two 3^ears to save very many
more than ever before in the same length of time from
sickness and death.
MEETINGS OF THE BOARD.
MINUTES OF THE ANNUAL MEETING AT
RALEIGH IN 1893.
Raleigh, N. C, May 10, 1893.
The North CaroUiia Board of Health met iii regular
annual session in the private office of the Yarborough
House at 6 p. m.
In the temporary absence of the President Dr. George
G. Thomas vras, on motion, called to the chair. Present
:
Drs. Bahnson, Harrell, Hodges, Thomas, Veuable, Mr.
Chase and the Secretary.
On motion of Dr. Venable the action taken by the Board
in the matter of the Quarantine Station at Southport by
letter was ratified.
Dr. Bahnson, for the committee appointed to visit the
School for the Deaf and Dumb at Morganton, and advise
the Board of Directors of the same as to a water supply
and system of sewerage, submitted a report of its work,
stating that a copy had been sent to Dr. M. L. Reid, Chair-man
of the Board of Directors. On motion the report was
accepted and indorsed.
A motion to proceed to the election of officers was car-ried,
but as some doubt was expressed as to the tenure of
office of the Secretary, whether he should hold for the un-expired
term to which he was elected under the old law
('85), or whether he should be elected every two years,
since the term of office of each member of the Board was
made b}'' the new law ('93) only two years, the President
was rec|uested to obtain the opinion of the Attorney Gen-eral
and report to the meeting next morning, to which
time the Board then adjourned.
RICH'D H. LEWIS,
Secretary.
10 NORTH CAROLINA BOARD OF HEALTH.
Raleigh, X. C, May 11, 1893.
The Board re-assembled in the Senate Chamber of the
Capitol at 10 a. .m., President Bahnson in the chair.
The President stated that he had consulted the Attorney
General as to the term of office of the Secretary and that
the latter had given it as his opinion that if the Secretary
continued a member of the Board by re-appointment for so
long a time he was entitled under the Constitution of the
State to hold the office for the remainder of the six-year
term of the late Secretar}^, Dr. Thomas F. Wood, to which
he was elected.
Dr. tienry T. Bahnson was nominated for President and
unanimously re-elected.
Messrs. Chase and Venable were appointed a committee
to audit the accounts of the Treasurer. They reported
them to be correct.
Adjourned.
RICH'D H. LEWIS,
Secretary.
FIFTH BIENNIAL REPOHT. 11
ACTION OF THE NORTH CAROLINA BOARD OF
HEALTH, IN jREGARD TO THE RESIGNATION
OF DR. J. A. HODGES AND THE ELECTION OF
HIS SUCCESSOR.
The following letter, which ex})lains itself, was sent to
every member of the Board
:
North Carolixa Board of Health,
Secretary's Office,
Raleigh, November 6, 1893.
My dear Doctor :—I am instructed by President Bahnson to notify
the members of the Board of the resignation, upon his removal from
the State, of Dr. J. A. Hodges, and to ask eacli member to indicate in a
letter to the Secretary (in order to save tlie expense of a meeting for the
purpose) what action he desires taken thereon, and his choice for his
successor.
Please write me promptly in accordance with the above and oblige,
Yours truly,
EICH'D H. LEWIS,
Secretary.
By the answers to the above letter received from all the
members of the Board, and now on file in the Secretary's
office, the resignation of Dr. Hodges was accepted and Dr.
John Whitehead, of Salisbury, was unanimously elected to
fill the vacancy.
Dr. Whitehead was duly notified of his election and
signified his acceptance of the position.
RICH'D H. LEWIS,
Secretary.
12 NOKTH CAROLINA BOARD OF HEALTH.
MINUTES OF THE ANNUAL MEETING AT
GREENSBORO IN 1894.
Greensboro, N. C, May 15, 1894.
TJie North Carolina Board of Health met in regular
annual session in Room 15, Benbow House, at 9 p. m.
There were present Drs. Bahnson, President; Harrell,
Whitehead and Venable, Mr. Chase and the Secretary.
• The minutes of the last meeting and of the action of
the Board in regard to the resignation of Dr. J. A. Hodges
and the election of his successor were read and approved.
Messrs. Chase and Venable were appointed by the Presi-dent
a committee to audit the accounts of the Treasurer.
The matter of the erection of a first-class Quarantine
Station at Southport was informally discussed. Great regret
was expressed at the action of the authorities of the city
of Wilmington in refusing to appropriate the $5,000 neces-sary
as a preliminary condition to receiving $20,000 from
the State.
The transmission of typhoid fever was the subject of a
general discussion of a very interesting character.
On motion it was ordered that the Board meet hereafter
three times a year—every four mouths—the annual meet-ing
to be held as usual with the State Medical Society, and
the other two in September and January at such place as
the Board may select and on such day as the President
may appoint.
On motion Salisbury was selected as the place for the
next or September meeting. The President was requested
to appoint the day at his convenience.
On motion it was ordered that the public institutions of
the State, including the convict camps, be inspected as far
as practicable during the current year.
FIFTH BIENNIAL REPORT. 13
On motion the Secretary was instructed to i)urchase a
library of reference books on sanitary subjects for the use
of his office, and also similar books for the use of members
of the Board.
Adjourned to 12 o'clock to-morrow.
RICH'D H. LEWIS,
Secretary.
Greensboro, N. C, May 1<3, 1894.
The Board re-assembled in Room 15 of the Benbow
House at 6:40 p. m.: President Bahnson in the chair.
Present: Drs. Bahnson, Battle, Harrell and Whitehead,
Mr. Chase, Passed Assistant Surgeon J. J. Kinyoun, M.
H. S., and the Secretary.
In response to an invitation from the Board to address
them, Dr. Kinyoun made the following statement:
The Surgeon General of the ]\Jarine Hospital Service,
Dr. Wyman, is very anxious to have all the larger ports
put in good shape. All the ports except Wilmington are
already well provided with quarantine facilities. It is his
earnest desire to have a perfectly equipped station at Wil-mington.
The rules under the law of February, 1893, re-quire
that the dunnage of any infected vessel must be
disinfected by steam and the hold of said vessel by 10 per
cent, sulphur. If such facilities do not exist at a port the
vessel must be remanded to a port that is supplied. This
would wreck the commerce of Wilmington as matters now
stand, which the Government would be very loth to do.
An order has been issued to captains from West Indies and
South American ports having yellow fever to report at once
to United States stations. All sailing vessels from an in-fected
port in West Indies are advised to go by one of the
national stations at Tortugas or Sapelo for inspection and
disinfection. The Surgeon General wishes to know if a
14 NORTH CAROLINA BOARD OF HEALTH.
properly equipped station cannot be established by the
State. If not the United States have the law and ample
means to do so.
After a full discussion of the above statement from the
Marine Hospital Service the following motion was intro-duced
by Dr. Battle and unanimously adopted
:
Moved, that in view of the inability or the unwillingness of the city
of Wilmington to contribute its part towards carrying out the act of the
last General Assembly providing for the erection of a first-class Quaran-tine
Station at Southport, the Secretary of this Board be instructed to
officially request the United States Marine Hospital Service to take charge
of and operate that station; and that the Secretary be authorized to
explain this action on the part of the Board.
The Auditing- Committee reported that they had exam-ined
the accounts of the Treasurer and found them correct.
Report adopted.
On motion the Board adjourned to meet in Salisbury in
Se^^tember.
RICH'D H. LEWIS,
Secretary.
MINUTES OF THE MEETING AT SALISBURY,
SEPTEMBER 13, 1894.
Salisbury, N. C, September 23, 1894.
The Board met after the adjournment of the Health Con-ference
in private session at the Central Hotel. Present:
Drs. Bahnsou, Battle, Thomas, Whitehead and Lewis.
Drs. Bahnson and Lewis were elected delegates to the
American Public Health Association. The appointment of
delegates to the National Conference of State Boards of
Health was left to the President. A letter from Dr. C. O.
Probst, Secretary of the National Conference of State Boards
of Health, stating that the annual dues of North Carolina
for 1892, $10, had not been paid, was read. Upon a state-
FIFTH 15IEXNIAL REPORT. 15
ment from the Treasurer of the Board that such was the
fact, due doubtless to the prolouged ilhiess of the Treasurer
at that tiuie, a motion was passed ordering it paid.
On motion the Secretary Avas ordered to have printed in
pamphlet form, and generally distributed, the article on
"The Prevention of Tuberculosis," by Dr. S. Westray Bat-tle,
and that on "Drinking Water in its Relation to Malarial
Diseases," by the Secretary, just read before the Health
Conference.
On motion Mr. J. C. Chase, the Engineer of the Board,
was requested to make a thorough inspection of the various
State institutions and of tlie water supplies and sewerage sys-tems,
present and prospective, of the more important cities
and towns of the State and to report the results of the same
to the Board.
On motion tlie meeting adjourned.
RICH'D H. LEWIS,
Secretary.
PROCEEDINGS HAD IX REGARD TO THE ELEC-TION
OF A PRESIDENT OF THE BOARD TO
SUCCEED DR. H. T. BAHNSON, RESIGNED.
Having been notified by his Excellency the Governor
of the resignation from the Board of Dr. H. T. Bahnson,
of Salem, for many j-ears its active and efficient President,
I addressed the following letters to each member of the
Board. They show the method of the election of Dr.
George Gillett Thomas, of Vvilmington, as his successor in
the presidenc}^ :
Raleigh, N. C, November 21, 1894.
My dear Doctor :—Dr. Bahnson, being a member of two boards, has
tbought it proper to resign from one of them, and has, I am sorry to
say, elected to give up ours. We are, therefore, without a President,
and tlie machinery of our law requires one. In order to save expense
and time it has occurred to me that it would be best for me to call for
16 NORTH CAROLINA BOARD OF HEALTH.
nominations by letter and then to send a list of the nominees to each
member of the Board for his ballot. If you approve this plan please
make a nomination. If not, let me have your views as to the best
course of action, and oblige,
Yours very truly,
RICH'D H. LEWIS,
Secretary,
P. S.—If a majority of the Board should nominate the same person
we will, if you approve, consider that an election. R. H. L.
Raleigh, N. C, December 8, 1894.
My dear Doctor:—The "returns" are all in, and Dr. G. G. Thomas
has been nominated by six (6) members and Dr. S. W. Battle by two (2)
members for President of the Board. According to the understanding
had in my former letter—that if any one member should happen to be
nominated by a majority of the Board we would, without further corre-spondence,
consider him elected—I now announce the election of Dr
George Gillett Thomas as President.
Very truly yours,
RICH'D H. LEWIS,
Secretary.
His ExcelleDcy the Governor appointed Dr. W. P. Beall,
of Greensboro, to fill the vacancy on the Board caused by
the resignation of Dr. Bahnson.
PROCEEDINGS
CONJOINT SESSIONS OF THE STATE BOARD OF HEALTH
WITH THE
State Medical Society in 1893 and 1894.
The Conjoint Session at Raleigh, May 11, 1893.
Dr. II. T. Bahnson was called upon to preside. He au-noLinced
the first business in order to be the reading of the
annual report of the Secretary :
ANNUAL REPORT OF THE SECRETARY OF THE
NORTH CAROLINA BOARD OF HEALTH.
By Richard H. Lewis, M. D., Raleigh, N. C.
By section 27 of the Act Relating to the Board of Health
the Secretary is required to submit his annual report at
this, the annual meeting of the Board. ITe is also required
by section 3 of the same to make biennially to the General
Assembly, through the Governor, a report of the work of
the Board. In comjdiance with the latter the fourth bien-nial
report for 1891-'92 was prepared and submitted, and
the portion of it covering the period from the last annual
meeting to January 1, 1893, is respectfully referred to as
a part of this report. [Read from the biennial report the
references to the life and work of Dr. Thomas F. Wood.]
On January 2d an invitation to meet with the State
Board of Health in a Health Conference on January 24th
18 NORTH CAROLINA BOARD OF HEALTH.
iu the city of Raleigh was mailed to the number of six
hundred and fifty to the officers of the State Government,
members of the General Assembly, Mayors of towns, County
Superintendents of Health, Chairmen of Boards of County
Commissioners, physicians and other prominent men. The
attendance was not ver}" large, but varied and of good
quality. The number of County Superintendents of Health
present (three, and one of them a member of the Legis-lature)
was discouraging, particularly in view of the fact
that one of the principal subjects for discussion named in
the invitation was their own salaries, about which much
complaint had been made. The following are the proceed-ings
of the Health Conference:
Raleigh, N. C, January 24, 1893.
On a call from the President of the State Board of
Health, Dr. H. T. Bahnson, of Salem, that body met in the
city of Raleigh on the above date, there being present Drs.
J. H. Tucker, J. A. Hodges, Geo. G. Thomas, Prof. F. P.
Amenable and the Secretary.
There were present also Superintendents of Health, prac-ticing
physicians and other citizens interested in sanitation
and the health of the State, all of whom were invited to
meet with the State Board of Health in a Health Con-ference.
In the absence of President Bahnson the Secretary called
the Conference to order, stating the object of the Confer-ence
to be a consideration of the best method to prevent
the introduction of pestilential diseases into the State, the
method of fixing the salaries of Superintendents of Health
and other matters relating to the general health of the
State.
He introduced the Mayor of the cit}^ of Raleigh, who
extended a cordial welcome to the Conference and assured
FIFTH BIENNIAL KEPOKT. 1 H*
it of his hearty support in its efforts to [)romote the welfare
of the State in the all-important matter of healtli.
The first order of business being the selection of a perma-nent
chairman, Dr. Thomas nominated Col. W. 11. S.
Burgwyn, a man who had shown himself to be actively
interested in the health matters of North Carolina. Col.
Burgw}'!! was unanimously elected Jind on assuming the
cliair expressed himself as feeling highly honored by being-invited
to preside over the meeting and gladly offered all
the assistance in his power to the Conference in improving
the safeguards against the ravages of plagues and epi-demics.
The prosperity of the country is largely dependent
upon the medical profession, and this is especially note-worthy
of the next twelve months when the country is to
undertake the stupendous task of entertaining the whole
world and, at the same time, guard her citizens from the
terrible plague which caused such destruction of life in
Europe last 3''ear and wliich is apparently only waiting for
the ap})roach of warm weather to renew its work of devas-tation
and destruction.
The Secretary presented as the first duty of the Con-ference
the amendment of the health laws of the State,
and read a co])y of a law suggested by the President, after
which he stated that a substitute for the old law had been
drawn up by himself for the consideration of the Con-ference.
It was moved and decided that the Secretarv read his
proposed substitute for the existing laws section by section
and if there be no objection raised the section be consid-ered
as approved by the Conference.
Section 1. Adopted without objection.
Sec. 2. There being some doubt as to whether the pro-posed
reading would call for the election of six new mem-bers
of the Board this year, it was corrected to make the
20 NORTH CAROLINA BOARD OF HEALTH.
fact clear that the successors of the present incumbents
were to be elected only at the expiration of the terms of
the present members; each new member being elected for
six years.
Sec. 3. The important part of this section is the duty of
the Board to inspect the public institutions of the State,
and the Secretary explained that before any action was
taken he had communicated with the chief officers of the
asylums and of the Penitentiary and they had expressed
the opinion that such inspection would be very proper and
desirable. The section was approved ; but later Dr. .J. W.
Jones thought that the inspection of the stockades should
be made oftener than once a year, as frequently a stockade
was not in existence so long as a year, and in that event it
might not be inspected at all. An amendment was added
to the section, providing for inspection as much oftener as
requested by the "Board of Charities." The Secretary said
that he had considered the advisability of having the
superintendents of the public institutions make monthly
reports to the Board of Health, but as the}' have to keep a
record of these things any way, and include them in their
regular reports, he thought it not well to impose this duty
upon them.
Sec. 4. Approved without discussion.
Sec. 5. This section was amended so as to make eligible
to membership in the County Boards of Health all prop-erly
registered physicians.
Sec. 6. Dr. Hodges thought the law regarding fines
against Superintendents had been a dead law ; that he be-lieved
these fines had never been collected. He had at
times been delinquent in sending in his reports when he
was a Superintendent and had never paid a fine. The Sec-retary
explained that heretofore it had not been obligatory
on the Secretarv to notifv the Countv Commissioners of the
FIFTH BIENNIAL REPORT. 21
delinqiioiicy of the Supcniiteiulents. On motion the sec-tion
was amended, making it the duty of the Secretary of
the State Board to notify tlio Commissioners on the 11th of
each month of any delinquenx?.y on the part of Superin-tendents
to send in their reports by the 10th. As amended
the .section was adopted.
Sec. 7. This section, relating to the salaries of Superin-tendents
of Health, provoked a very great deal of discus-sion
by the members of the Conference generally. The
Secretary thought the salaries of these officers should be
imposed and regulated by legislative enactment so that
they could act independently in performing their duties.
There was a unanimity of opinion as to the fact that the
salaries of the Superintendents were far from satisfactory,
but there seeming to be an inabilitv to come to any con-elusion
as to the best and wisest plan for improving them,
Dr. Hodges moved that the matter be referred to a com-mittee
who should consider it and report at the afternoon
session. The motion was carried.
Sec. 8. The Secretary explained that this section was
introduced in its proposed form for the purpose of making
one definite day for the election of Superintendents in all
the counties of the State, and so that all terms of office
would expire at the same time. Dr. Thomas thought the
reason why local Boards of Health held such infrequent
meetings was because they were invested with no power
except to give advice and their advice generally resulted
in nothing. The section was adopted.
Sec. 9. Adopted.
Sec. 10. Adopted.
Sec. 11. Adopted.
Sec. 12. Adopted.
Sec. 13. Dr. Hodges thought we ouglit to deal with
great tenderness with the affairs of the public schools.
22 NORTH CAROLINA BOARD OF HEALTH.
Some committeemen lived ten miles apart, and it would
be bard to get tbem togetber to consider these tilings.
Tbe Secretary exrjlained that it was only tbe diseases tbat
were really dangerous to life tbat were included in tbis
section. The section is intended to apply especially to
city schools, but should also apply to county schools. Dr.
Grouse thought tlie last clause requiring tbe child wdio
persisted in coming to school while it was in dangerous
contact with contagious diseases at home, to be dismissed
from the school for the remainder of tbe term, a hardship
on tbe child and not a punishment on the pareut, where
the blame should rest. After some discussion it was
decided to leave tbis clause out, and as so amended the
section was passed.
Sec. 14. Adopted.
Sec. 15. Amended so as to provide for tbe early removal
of a suspect from tbe State, and was then adopted.
Sec. 16. Adopted after a slight amendment.
Sec. 17. This section was explained to refer to potable
waters. It was then adopted.
Sec. 18. Adopted after a slight amendment.
The remaining sections were adopted without much
discussion.
TJie Chair attempted to appoint the committee to take
into consideration the matter of salaries of Superintend-ents
of Health, but there were none willing to assume the
office, and on motion it was referred back to tbe whole
meeting for action and then postponed to the afternoon
session.
Tbe Conference then adjourned to o p. m.
FIFTH BIENNIAL KEPOKT. 23
AFTEKNOON SESSION.
The Contereiice \va.s called to order by the Chairman at
J o'clock.
Section 7, relating to salaries of Superintendents, was
introduced as the first order of business and again evoked
much discussion, with liual result of ado])ting the section
as it now stands.
The matter of taking some action luokmg to seeuriug
some law of compulsory vaccination elicited quite a spir-ited
debate. All present seemed to agree as to the desira-bility
of a more general practice of vaccination, but some
were doubtful as to the advisability of attempting to
secure legislation to require vaccination just at present, as
it might jeopardize the whole bill.
On motion the whole bill was adopted as a substitute
for the present Act Helating to the Board of Health.
By invitation Dr. W. G. Curtis, Quarantine Physician of
the station at the month of the Cape Fear river, read a
paper with a description of the station as it now is, a
recital of the needs of the station and a discussion of the
probability of cholera getting into this State the coming
summer.
During the latter part of the meeting Dr. Geo. G.
Thomas presided, as Col. Burgwyu was obliged to leave.
After the reading of Dr. Curtis's paper, which was lis-tened
to with much interest, the Conference adjourned
sine die. RICH'D H. LEWIS,
Secretary.
Upon request the President of the Senate and the
Speaker of the House announced a joint meeting of their
respective Committees on Public Health—the first com-mittees,
by the way, on public health ever appointed by
any Legislature in the history of the State, I am told—for
24 NORTH CAROLINA ROARD OF HEALTH.
the niglit aftor the adjournment of tlie Conference, to con-sult
with niemhors of the Board of Health in regard to
sanitary matters generally, and the proposed legislation in
the interest of the puhlic health in particular. Messrs.
Hodges, Venable, Thomas and the Secretary appeared
before them, and the bill was read over and explained.
Senator Lucas, of Bladen (;ounty. Chairman of the Senate
Committee on Public Health, who had just been appointed
on the Board by Governor Carr, took charge of the bill
and introduced it in the Senate. The Secretary again
appeared before the Senate Committee, to which it was
referred on its introduction, and it was favorably reported
with unanimity. He also had a number of personal inter-views
with Senators in regard to the importance of the act
and besides sent a letter with a copy of the act to about
one hundred physicians, County Superintendents and others,
urging them to use their influence with their Senators and
Representatives in effecting the passage of the bill.
This letter bore fruit, and after some delay and much
vexation of spirit on the part of your Secretary the bill
passed the Senate by a vote of thirty-four to eight, though
somewhat damaged by amendments. The House Com-mittee
unanimously recommended its passage. Notwith-standing
that fact when it came up on its second reading it
was laid on the table in short order by a considerable
majority, wdiich of course would have been the end of it but
for the tact and parliamentary skill of the Hon. Edmund
Jones, of Caldwell, a warm personal friend of 3'our Secre-tary,
who got it up again and with the active assistance of
a number of the best men in the House, medical and lay,
secured its passage. I was very anxious to have some of
the Senate amendments corrected in the House, but our
friends in that body advised strongly against attempting
anv amendment on the ground that if they ever began to
FIFTH BIENNIAL REPORT. 25
amend it it would probably come out in worse shape than
the Senate had left it. Your Secretary deferred to their
wisdom, feeling that it was better to take what we had than
to run a serious risk of losing much more.
The act as finally passed differs from that proposed by
the Health Conference essentially in these particulars: The
appointment of five members instead of three out of the
nine is given to the Governor and the term of office of all
is made the same, two j'ears—an unfortunate change, I
think, in both respects.
The annual appropriation of $3,000 asked for was cut
down to $2,000, the same as heretofore. In other respects
it is essentiallv as introduced.
On the whole we have made a decided advance, as a com-parison
of the new with the old lavr will clearly show, I
think. The old law, which was incorporated in the new,
was imjjroved in many respects and many new and valua-ble
sections, providing for much better protection against
the introduction and spread of contagious and infectious
diseases, and for the preservation of water su^^plies, as well
as improvements in other respects, were added. AVhile our
annual appropriation was not increased in dollars it was
materially augmented by the removal of the $250 limit to
our requisition on the State Printer for stationery and print-ing.
The emergency fund was also increased from $2,000
to $5,000. The following is the law as it now stands:
AN ACT IX RELATION TO THE BOARD OF HEALTH, RATIFIED
MARCH 1, 1893.
The General Assembly <>f Xortlt Carolina do enact
;
Section 1. That the Medical Society of the State of North Carolina
shall choose from its members by ballot four members, and the Governor
of the !^tate shall appoint five other persons (one of -whom shall be a
sanitary engineer) and they shall constitute "The North Carolina Board
of Health."
26 XOETH CAROLINA I50AKD OF HEALTH.
Sec. 2. The members of the Board of Health elected by the State Medi-cal
Society shall be chosen to serve two years. Their term of office shall
begin immediately upon the expiration of the meeting at which they
were elected. Those appointed by the Governor shall serve two years,
their term of otHce beginning with the first regular meeting of the Board
after their appointment. In case of death or resignation the Board shall
elect new members to fill the unexpired terms : Proridcd, the Governor
shall fill such vacancies as may occur where he has made appointments.
Sec. 3. Tliat the Xortli Carolina Board of Health shall take cognizance
of the health interests of the people of the State, shall make sanitary
investigations and inquiries in respect to the people, employing experts
when necessary ; shall investigate the causes of disease dangerous to tlie
public health, especially epidemics, the sources of mortality, the effect
of locations, employments and conditions upon the public health. They
shall gather such information upon ail these matters for distribution
among the people, with the especial purpose of informing them about
preventable diseases. They shall be the medical advisers of the State
and are herein specially provided for, and shall advise the government
in regard to the location, sanitary construction and management of all
State institutions, and shall direct the attention of the State to such sani-tary
matters as in their judgment affect the industries, prosperity, h.ealth
and lives of the people of the State. They may make an inspection once
in each year, and at such other times as they may be requested to do so
by the State Board of Charities, of ail public State institutions, including
all convict camps under the control of the State Penitentiary, and make
a report as to their sanitarj^ condition, with suggestions and recommenda-tions
to their respective boards of directors or trustees ; and it shall be
the duty of the officials in immediate charge of said institutions to fur-nish
all facilities necessary for a thorough inspection. The Secretary of
the Board sliall make biennially to the General Assembly, through the
Governor, a report of their work.
Sec. 4. The State Board shall have a President and a Secretary, wiio
shall also be Treasurer, to be elected from the members composing the
Board. The President shall serve two years and the Secretary-Treasiirer
two years. The Secretary-Treasurer shall receive such yearly compensa-tion
for his services as shall be fixed upon by the Board, not to exceed
one thousand dollars, but the other members of the Board shall receive
no pay, except that each member shall receive four dollars a day and
necessary traveling and hotel expenses when on actual duty attending
the meetings of the Board or pursuing special investigations in the State,
but when attending important sanitary meetings in other sections, the
number of delegates thereto being limited to two, only actual traveling
and hotel expenses shall be allowed. These sums shall be paid l>y the
Treasurer on authenticated requisition approved and signed by the Presi-dent.
FIFTH BIENNIAL REPORT. 27
Sec. 5. There shall be an auxiliary Board of Health in each county in
the State. These Boards shall be composed of all registered physicians
resident in the county, the ^layor of the county town, the Chairnian of
the Board of County Commissioners and the City Surveyor, when
there is such an otiicer; otherwise the County Surveyor. From this
number one physician shall be chosen by ballot to serve two years, with
the title of Superintendent of Health. His duty shall be to gather vital
statistics upon a plan designated by the State Board of Health. He shall
always promptly advise the Secretary of the State Board of tlie unusual
prevalence of disease in his county, especially of typhoid fever, scai'let
fever, diphtheria, yellow fever, small-pox, or cholera. His reports shall
be made regularly, as advised by the State Board, through their Sec-retary;
and he shall receive and carry out as far as possible such
work as may be directed by the State -Board of Health. He shall
make the medico-legal posf-rnorton examinations for coroners' inquests,
and attend the prisoners in jail, home for the aged and infirm, and house
of correction, and make an examination of lunatics for commitment. He
shall be the sanitary inspector of the jail and home of his county, mak-ing
monthly reports to the Board of County Commissioners : Provided,
that if for any cause tlie County Board of Health should fail to meet as
hereinafter set forth and elect a Superintendent, the County Commis-sioners
shall elect from those physicians resident in the county eligible
to membership in the County Board a Superintendent of Health : Pro-vidi'd
farther, that it shall be unlawful for said County Commissioners to
elect any one not eligible to membership in the County Board to the office
of County Superintendent of Health, if any such qualified physician can
be found in the county willing to accept the office.
Sec. 6. IMonthly returns of vital statistics, upon a plan to be made by
the State Board of Health, or their Secretary acting under their instruc-tions,
shall be made by the County Superintendent to the Secretai-y of
the State Board, and a failure to report by the tenth of the month for
the preceding month shall subject the delinquent to a fine of one dollar
for each day of delinquency, and this amount shall be deducted from
the salary of the Superintendent by the Boardof County Commissioners
on the statement of such delinquency by the Secretary of the State Board
of Health; and the said Secretary is hereby required to notify, on the
eleventh day of each month, the Chairman of the Board of County Com-missioners
of such delinquency. The County Superintendent shall report
to the Secretary of the State Board the presence in his county of any case
of small-pox, yellow fever, typhus fever or cholera within twenty-four
hours after it has come to his knowledge, and upon failure to make such
report within the prescribed time the County Commissioners shall
deduct five dollars from his salary for each day of delay in reporting.
Sec. 7. The salary of the County Superintendent of Health shall be
28 NORTH CAROLINA BOARD OF HEALTH.
paid out of the county treasury upon requisition and the proper
vouchers as follows: The salary of the Superintendent of Health, or
any other member of the Board who is requii-ed to do the service
assigned him, sliall be in accordance witli the medical fees usual in his
county, and for each inspection of the jail and county home, which he
shall make monthly, he shall be paid as for one medical visit : Prodded,
that a definite salary of not less than ten nor more than one thousand
dollars may be paid in lieu of fees if mutualh^ agreeable to the Board of
County Commissioners and the County Superintendent.
Sec. 8. The biennial meeting for the election of officers shall be, for
the State Board of Health, on the second day of the annual meeting of
the Medical Society of tlie State of North Carolina in eighteen hundred
and ninety-three and every two years thereafter; for the County Boards
it shall be held in the county court-house between the hours of 12 >f.
and 1 V. y\. on the first Monday in September, eighteen hundred and
ninety-thi-ee, and each two years thereafter: Frurided, that the two-year
term of office of any Superintendent shall not be curtailed thereby
;
but his successor, who shall be elected at the meeting on the first Mon-day
in September, eighteen hundred and ninety-tiiree, shall qualify upon
the expiration of said term and hold office until the first Monday in
September, eighteen hundred and ninety-five, Mhen all County Superin-tendents
shall be elected for the full term of two years, beginning and end-ing
with the first ^Monday in September. In order to secure uniformity
and certainty of action it shall be the duty of the Secretary of the State
Board of Health to mail to every person in the State eligible to member-ship
in the County Boards of Health, whose address can be obtained, on
or before the twentieth day of the August next preceding the time of meet-ing
hereinbefore appointed, a printed notice of said meeting setting forth
time and place.
Sec. 9. Inland quarantine shall be under the control of the County
Superintendent of Health, who shall see that diseases especially dan-gerous
to the public health, viz., small-pox, diphtheria, scarlet fever,
yellow fever, typhus fever and cholera, are proj)erly quarantined and iso-lated
within twenty-four hours after the ca.se is brought to his knowledge ;
and that after the death or recovery or removal of a person sick of either
of the diseases mentioned the rooms occupied and the articles used by
the patient are thoroughly disinfected in the manner set forth in the
printed instructions, both as to quarantine and disinfection, which shall
be furnished him by the Secretary of the State Board of Health. The
expense of the quarantine and of the disinfection shall be borne by the
householder in whose family the case occurs, if able; otherwise by the
city, town or county of which he is a resident. The failure on the part
of a County Superintendent of Health to perform the duties imposed in
this section shall be punished by the deduction of five dollars for each
FIFTH BIENNIAL REPORT. 29
day of delinquency from his salary by the Board of County Commis-sioners
; and if it shall appear to the satisfoction of the County Board
of Health that the death of any person from the spread of the disease
can justly be attributed to such failure of duty on his part, he shall be
deposed from office and a successor immediately elected to fill out his
unexpired term. Any person neglecting or refusing to comply with or
in any way violating the rules promulgated in the manner above set
forth on the subjects of quarantine and disinfection shall be deemed
guilty of a misdemeanor, and upon conviction shall be fined or impris-oned,
at the discretion of the court, not less than five nor more than
fifty dollars, or less than ten nor more than thirty days. In case the
offender be stricken with the disease for which he is quarantinable, he
shall be subject to the penalty on i-ecovery, unless in the opinion of
the Superintendent it should be omitted : Provich-d, hoirerer, that in any
city or incorporated town having a regularly appointed medical health
officer who is a member of the County Board of Health, the duties
assigned in this section to the County Superintendent of Health shall be
performed by the said medical health officer for the people of his city
or town, and he shall be subject to the same penalties for dereliction of
duty at the hands of the Board of Aldermen or Town Commissioners as
are directed to be imposed by the County Commissioners and County
Board of Health upon the Superintendent: Frotided further, that the
quarantine of ports shall not be interfered with, but the officers of the
local and State Boards shall render all aid in their power to quarantine
officers in the discharge of their duties upon the request of the latter:
Provided, tliat the custody and care of any child or other person may
remain in custody of parent or family.
Sec. 10. Wiien a householder knows that a person within his family
is sick with either of the diseases enumerated in section nine he shall
immediately give notice thereof to the health officer or Mayor, if he
resides in a city or incorporated town, otherwise to the County Superin-tendent
of Health, and upon the death or recovery or removal of such
person the rooms occupied and the articles used by him shall be disin-fected
by such householder in the manner indicated in Section Nine.
Any person neglecting or refusing to comply with any of the above pro-visions
shall be deemed guilty of a misdemeanor, and upon conviction
shall be fined not less than one dollar nor more than fifty dollars.
Sec. 11. When a physician knows that a person whom he is called to
visit is infected with small-pox, diphtheria, scarlet fever, typhus fever,
yellow fever or cholera he shall immediately give notice thereof to the
health officer or :\Iayor, if the sick person be in a city or incorporated
town, otherwise to the County Superintendent of Health, and if he
refuses or neglects to give such notice of it in tv\enty-four hours he shall
be guilty of a misdemeanor and shall be fined for each offen-e not less
30 NORTH CAROLIXA BOARD OF HEALTH.
than ten nor more than twenty-five dollars. And it shall be the duty
of the said County Superintendent, health officer or 3Iayor receiving
such notice of the presence of a case of small-pox, yellow fever, typhus
fever or cholera within his jurisdiction to communicate the same
immediately by mail or telegraph to the Secretary of the State Board of
Health. A failure to perform this duty for twenty-four hours after the
receipt of the notice shall be deemed a misdemeanor, and shall subject
the delinquent njton conviction to a fine of not less than ten nor more
than twenty-five dollars.
Sec. 12. The County Superintendents of Health, or the Boards of Health
in the several cities and towns where organized, otherwise the authoi'i-ties
of said cities or towns, shall cause a record to be kept of all reports
received in pursuance of the preceding sections, and such records shall
contain the names of all persons who are sick, the localities in which
tiiey live, the diseases with which tliey are alfected, together with the
date and names of all persons reporting any such cases. The Boards of
Health of cities and towns wherever organized, and where not the
Mayors of the same, and in other cases the County Superintendent of
Health, shall give the .school committee of the city or town, the princi-pals
of private schools and the Superintendent of Public Instruction of
the county, when the schools are in se.'^sion, notice of all such cases of
contagious diseases reported to them according to the provisions of this
act. A failure to perform this duty for twenty-four hours after the
receipt of the notice shall be deemed a misdemeanor, and subject the
delinquent upon conviction to a fine of not less than ten nor more than
fifty dollars.
Sec. Ii5. The school committees of public schools, superintendents of
graded schools and the principals of private schools shall not allow any
pupil to attend the school under their control while anj^ member of the
household to which said pupil belongs is sick of either small-pox, diph-theria,
measles, scarlet fever, yellow fever, typhus fever or cholera, or
during a i)eriod of two weeks after the death, recovery or i-emoval of
such sick person ; and any pupil coming from such household shall be
required to present to the teacher of the school the pupil desires to
attend a certificate from the attending physician, city health officer or
County Superintendent of Health of the facts necessary to entitle
him to admission in accordance with the above regulations. A wilful
failure on the part of any school committee to perform the duty required
in this section shall be deemed a misdemeanor, and upon conviction
shall subject each and every member of the same to a fine of not less
than one nor more than twenty-five dollars : Provided, that the instruc-tions
in accordance with the provisions of this section given to the
teachers of the schools within twenty-four hours after the receipt of each
and every notice shall be deemed performance of duty on the part of
FIFTH BIEXXIAL REPORT. 31
the school committee. Any teacher of a i)ublic school and any ]n-inci-pal
of a private school failing to carry out the requirements of this sec-tion
shall be deemed guilty of a misdemeanor, and upon conviction shall
be lined not less than one nor more than twenty-tive dollars.
Sec. 14. When a person coming to a city or town from abroad or from
some other place in this State is infected or has lately been infected with
either of the diseases mentioned in Section Nine the local Board of
Health where such exists, otherwise the Board of Aldermen or Board
of Town Commissioners, shall make effective provision in the manner
which it judges best for the safety of the inhabitants by removing such
person to a separate house or otherwise, and by providing nurses and
other assistance and necessaries, whicii shall be at the charge of the
person himself or hisixirents, where able, otlierwise at the charge of the
city, town or county to which he belongs.
Sec. 15. The Board of Health, or, in case there is no Board of Health,
the Board of Aldermen or Town Commissioners of a city or town near
to or bordering upon either of tb.e neighboring States, may appoint, by
writing, suitable persons to attend at places by whicii travelers may pass
from infected places in other States, who may examine such travelers as
may be suspected of bringing any infection dangerous to the public
health, and if it need be may restrain them from traveling until licensed
thereto by the Board of Healtii or Board of Aldermen or Town Com-missioners
of the city or town to which they maj' come. A traveler
coming from such infected places who, without such license, travels within
this State (except to return by the most direct route to the State whence
he came) after he has been cautioned to depart by the persons so
appointed, shall be isolated or ejected, at the discretion of the local city
or town or county Board of Healtii ; and upon refusal to comply with
the regulations of the said Boards of Health or either of them on this
subject shall be guilty of a misdemeanor, and upon conviction shall be
fined not less than twenty-five nor more than fifty dollars or imprisoned
not more than tliirty days. And all common carriers bringing into this
State any such persons as named above are hereby required to return
them to some point without this State, if required by a city, town or
county Board of Health. Nothing in this section shall prevent the State
Board of Health in time of epidemics from appointing such additional
examiners as they may deem necessary to the preservation of the public
health.
Sec. 16. No railroad corporation or other common cari-ier or person
shall convey or cause to be conveyed through or from any city, town or
county in this State the remains of any person who has died of small-pox,
measles, scarlet fever, diphtheria, typhus fever, yellow fever or
cholera until such body has been disinfected and encased in such manner
as shall be directed by the State Board of Health, so as to preclude any
32 NORTH CAROLINA BOARD OF HEALTH.
danger of (.•oinmnnicatiiig the disea^^e to others by its transportation ; and
no local registrar, clerk or heaUli otlicer, or any other person, shall give
a permit for the removal of such body until he has received from the
Board of Health of the city, or from the Board of Aldermen or Town
Commissioners, or the County Superintendent of the city, town or county
where the death occurred, a certificate stating the cause of death and
that the said body had been prepared in the manner set forth in this
section; which certificate shall be delivered in duplicate to the agent or
person who receives the body, and one copy shall be pasted on the box
containing the corpse ; said certificate shall be furnished in blank by the
transportation company wh.en no local board of health exists. During
an epidemic of cholera all common carriers shall so arrange their water-closets
as to catch in water-tight receptacles the dejections of all persons
using the same and shall disinfect the said dejections in a manner satis-factory
to the State Board of Health befoi'e emptying them. Any person
violating the provisions of this section shall be punished by fine not
exceeding twenty-five dollars.
Sec. 17. In times of epidemics of small-pox, yellow fever, typhoid
fever, scarlet fever, diphtheria, typhus fever, cholera, the State Board of
Health shall have sanitary jurisdiction in all cities and towns not having
regularly organized local boards of health, and are hereby empowered to
make all such regulations as they may deem necessarj- to protect the
public health, and to enforce, in courts of justices of the peace, the same
by the imposition of sucii penalties as come within tlic jurisdiction of a
justice of the peace.
Sec. is. Water and icater siipph/.—The State Board of Health .shall liave
the general oversight and care of all inland waters and shall from time to
time, as it may deem expedient, cause examinations of the said waters to
be made for the purpose of ascertaining wliether the same are adapted
for use as sources of domestic water sui)])lies, or are in a condition likely
to iiupair the interests of the public or persons lawfullj' using the same,
or imperil the public health. For the purpcses aforesaid it may employ
such expert assistance as may be necessary.
Sec. li). The said Board shall from time to time consult with and advise
the boards of directors of all State in.stitutions, the authorities of cities
and towns, corporations or firms already having or intending to introduce
systems of water supply, drainage or sewerage, as to the most appropriate
source of supply, the best practicable method of assuring the purity
thereof, or of disposing of their drainage or sewerage, having regard to
the present and prospective needs and interests of other cities, towns,
corporations or firms which may be affected thereby. All such boards
of directors, authorities, corporations and firms are hereby required to
give notice to said Board of their intentions in the premises and to sub-mit
for its advice outlines of their jnoposed plans or schemes in relation
FIFTH BIENNIAL RKPOKT. So-to
water .sni)ply and dis}n)sal of sewage, and no contraet sliall be entered
into by any State institution, city or town for the introduction of a sys-tem
of water supply or sewage dis})osal until said advice shall have
been received and considered: Pruriiled, Jiou-frcr, that any city or town
having a regularly organized Board of Health may seek advice therefrom
or from its County Boai'd of Health in lieu of that of the State Board.
Sec. 20. "Whoever willfully or maliciously defiles, corrupts or makes
impure any well, spring or otlier .source of water supply or reservoir, or
destroys or injures any pii)e, conductor of water or other property per-taining
to an aqueduct, or aids and abets in any such trespass, shall be
guilty of a misdemeanor, and on conviction shall be fined not exceeding
one thousand dollars or imprisoned not exceeding one year.
Sec. 21. Any hou.seholder in whose family there is to his knowledge a
person sick of cholera or typhoid fever, who shall permit the bowel dis-charges
of such sick person to be emptied without first having disinfected
them according to the instructions to be obtained from the attending
physician or the County Superintendent of Health shall be guilty of
a misdemeanor, and upon conviction shall be fined not less than two nor
more than twenty-five dollars, or imprisoned not less than ten norjnore
than thirty days. And in cases where such undisinfected discharges are
emptied on the water shed of any stream or pond furnishing the source
of water supply of any public institution, city or town the penalty .shall
be a fine of not less than twenty-five nor more than fifty dollars, or
imprisonment for not more than thirty days. And any i)hysician attend-ing
a case of cholera or typhoid fever who refuses or neglects to give the
proper instructions for such disinfection as soon as the diagnosis is made
shall be deemed guilty of a misdemeanor, and upon conviction shall be
fined not less than ten nor more tlian fifty dollars.
Sec. 22. Whenever and wherever a nui.sance upon premises shall exist
which in the opinion of the County Superintendent of Health is danger-ous
to the public health, it shall be his duty to notify in writing the
parties occupying the premises (or the owner, if the premises are not
occupied) of its existence, its character and the means of abating it. X^pon
this notification the pjarties shall proceed to abate the nuisance, but fail-ing
to do this shall be adjudged guilty of a misdemeanor and shall pay a
fine of one dollar a day dating from twenty-four hours after the notifica-tion
has been served, the amounts so collected to he turned over to the
County Treasurer: Prodded, hoiren'r, that if the party notified shall
make oath or afiirmation before a justice of the peace of his or her
inability to carry out the directions of the Superintendent it shall 1)6
done at the expense of the town, citj' or county in which the offender
lives. In the latter case the limit of the expense chargeable to the town^
city or county shall not be more than one hundred dollars in any case:
ProriV/cr^ /*);//(('/•, that nothing in this section shall be construed to give
34 NORTH CAROLINA BOARD OF HEALTH.
the Supcriiiteiident the power to destroy or injure property without a
due process of law as now exists for the ahatement of nuisances.
Sec. 2;]. Vaccinatioii.—On the appearance of a case of small-pox in
any neighhorhood all due diligence shall be used by the Superintendent
of Health that warning shall be given, and all persons not able to pay
shall be vaccinated free of charge by him, and the County Superin-tendent
shall vaccinate every person admitted into a public institution
(jail, county home, public school) as soon as practicable, unless he is
satisfied ujion examination that the person is already successfully vac-cinated
; the money for vaccine to be furnished by the County Commis-sioners.
The authorities of any city y the Conference of Healtli Officers that
the emergency demanded the erection and operation of disinfecting
plants at seaport towns, the State Board of Health take ujj the question
and consider the advisability of making available the appropriation made
for this port b}' the last Legislature."
The following is an extract from a report of the proceedings of the
Conference: "Dr. H. B. Baker, of Michigan, offered the following,
which was unanimously adopted :
^ liesolred, That in the present emer-gency
every State maintaining a maritime quarantine should possess a
perfectly equipped station with all appliances necessary for thorough
disinfection of infected vessels, unless there are special reasons to the
contrary.' The last clause was added to cover the case of States like
New Jersey, whicli can avail themselves of the stations of neigldioring
States."
As this is a matter of urgent imi^ortance, in order to save delay and
the necessity of a special meeting of the Board so near the time of the
regular meeting on the 10th pi'ox., I would thank you for an immediate
expression of opinion by letter on the question. If a majority of tlie
Board reply in the afiirmative, and the Governor approves, the Quarantine
Board would feel authorized to give out the contracts at once, and more
regular action could be taken by the Board of Health when it meets, if
deemed necessary.
The facts on which the above letter is based are these : The last Legis-lature
appropriated •'?20,000 for a modern disinfecting jilant at Southport,
which now has none at all, but attached the condition that the money
should not be available until "in the opinion of the Governor and the State
Board of Health the entrance of cholera into the port is imminent."
Upon the construction of the word "imminent" hangs the decision. In
Worcester's Comprehensive Dictionary the word "imminent" is detined
"impending; threatening; near," tlie only meanings given. In th.e opin-ion
of the recent Conference alluded to in the letter quoted cholera is
"impending; threatening; near," as it doubtless is in the oi)inion of
nearly every other person of any sanitary experience, owing to our con-stant
intercourse with western FAirope. In this case the word imminent
could not be taken to mean something "about to fall on the instant,"
for it would be manifestly absurd to wait until a ship with cholera on
board had entered the mouth of the Cujie Fear before giving out the con-tract
for apparatus requiring two or three months for its construction to
prevent the entrance of the disease. So that in the opinion of the under-signed,
as well as of two other members of the Board with whom he has
38 XOIITH CAROLINA KOARD OF HEALTH.
spoken, "the diiiigev of the entrance of cholera into the port of Wilming-ton
is imminent" in the sense in which the word can alone be reasonably
applied to the case in hand. Please let me know by return mail whether
yon agree or disagree with that opinion. Not a day is to be lost if any
thing is to be done.
Very truly yours,
RICH'D H. LEWIS,
Secrrtary.
To tliis ictter replies were received from all the members,
only one opposing the approi)riation. As soon as a majority
had been heard from, reahzing the importance of getting to
work on the Quaraiitine Station at the earliest possible
moment, I wrote to his Excellency Governor Carr, who
was then at Rocky Mount, which letter was delayed in
reaching him. Immediately npon his return to the capital
I laid the matter with the correspondence before him. He
appointed an hour the same afternoon for me to call for his
decision, but before it arrived he was unexpectedly sum-moned
to Newbern. On his return, having received replies
from every member of the Board, I addressed to him this
communication:
May ], 1893.
His Excellency Elias Carr, Governor of Xorili Cnroluia,
Sir:—Since my communication of the 17th ult., addressed to you at
Rockj'^ Mount, stating that "replies from a majority (of the Board of
Health) expressing the opinion that 'the entrance of cholera into the
portof Wilmington as imminent' had been received," I have heard from
every member. The replies from eight are as above, and from one to the
effect that the entrance of cholera is no more imminent now than at the
time of the passage of the act. I beg to dissent from that oiiinion, for the
reason that a number of fresh cases have occurred on the west coast of
Europe since the adjournment of the Legislature, and sanitarians now
consider the outlook for the summer very gloomy.
The Quarantine Board of Wilmington now awaits the concurrence of
your Excellency in the opinion of the State Board of Health, a.s required
by the act, before beginning this work of such great importance in pro-tecting
the port and State from, the scourge which threatens us. With
great respect, Your obedient servant,
IlIOK'D H. LEWLS,
Secretary.
FIFTH BIENNIAL KEPORT. o9
To this letter the Governor rei:)lied as follows:
May 1, 1893.
Dr. Richard H. Lewis, Secretanj X. C. Board of Health, Raleigh, N. C
,
Dear Sir:—Eeplying to j'our kind favor of the 1st instant, I would
state, in accordance with your views and the other members of the State
Board of Health, and after viewing the situation as it is, that, section 2 of
the act to amend section 2915 of The Code as follows : "For the purpose of
carrying into effect the provisions of section 2915 as herein amended the
sum of twenty thousand (?20,000) dollars is hereby appropriated out of
any moneys in the State Treasury not otherwise appropriated, to be paid
from time to time, as required in the prosecution of the work, on the
requisition of the Treasurer of the Quarantine Board and aj)proved by
its President: Provided, that the funds appropriated by this act shall
not be paid over by the Treasurer until the Governor and State
Board of Health of North Carolina shall certify to the Treasurer that
there is imminent danger of cholera visiting the city of AVilmington or
other sections of the State," makes it my plain duty to inform j^ou that
the amount appropriated ($20,000) is now available, and can be used
in carrying out the pi-ovisions of the act.
With highest esteem, I am, Yours very truly,
ELIAS CARE,
(rorernor.
I immediately wired the Secretary of the Quarantine
Board of AVilmington:
Govei'nor approves. Go ahead. If. H. LEWIS,
Secretary.
Afterwards I wrote him as i'oilows :
May 2, 1893.
Dr. Geo. G. Thomas, Secretary Board of Quarantine, Port of Wllmingtoii,
My' dear Doctor:—In compliance with your communication of the 11th
ult., calling upon the State Board of Health to "take up the question
and consider the advisability of making available the appropriation
made for the port by the last Legislature," I addressed a letter setting
forth the facts to each member of the Board. Replies from all v>ere
duly received—eight voting in favor and one against complying with the
condition necessar\' to make the appropriation available.
The whole correspondence was laid before his Excellency, the Gov-ernor,
at the earliest opportunity, and to-day I received his decision. I
inclose his letter, w'hich, after submitting it to your Board, you will
please return and oblige.
Yours trulv.
RICH'D H. LEWIS, :\I. D.,
3 Secretary.
40 NORTH CAROLINA BOARD OF HEALTH.
While the securing of a quaruutine station with all the
modern improvements for our chief seaport, a work of the
liighest value, from a sanitary point of view, to the State,
•cannot be credited to our Board, it is gratifvino- to know
that the leader in that movement was one of our members.
Dr. George G. Thomas, who v\'as most ably assisted by Dr.
T. S. Burbank, Messrs. J. C. Stevenson, Alex. Sprunt and
•others. Thanks to their efforts and to our enlightened and
progressive Legislature North Carolina will soon be abreast
of the most advanced communities in the matter of mari-time
quarantine protection.
In the performance of the duty imposed upon me in
Section 9 of the Act Relating to the Board of Health I
prepared the following 23amphlet containing Instructions
for Quarantine and Disinfection :
INSTRUCTIONS FOR QUARANTINE AND DISINFECTION.
EXTRACT FROM SECTION NINE OF AN ACT RELATING TO THE BOARD
OF HEALTH, RATIFIED MARCH i, 1S93.
"Iiilaud quarantine shall be uuder the control of the County Superintendent of
Health, who shall see that diseases especially dangerous to the public health, viz.:
small-pox, diphtheria, scarlet fever, yellow fever, typhus fever and cholera, are prop-erlj'
quarantined and isolated within t\vent3--four hours after the case is brought to his
knowledge; and that after the death or recovery' or removal of a person sick of either
of the diseases mentioned, the rooms occupied and the articles used by the patient are
thoroughlj- disinfected in the manner set forth in the printed instructions, both as to
quarantine and disinfection, which shall be furnished him bj' the Secretary of the
State Board of Health. The expense of the quarantine and of the disinfection shall be
t>orne by the householder in whose family the case occurs, if able, otherwise by the cit}',
town or county of which he is a resident. * * * Any person neglect-ing
or refusing to comply with or in any way violating the rules promulgated in the
manner above set forth on the subjects of quarantine and disinfection shall be deemed
guiltj- of a misdemeanor, and upon conviction shall be fined or imprisoned, at the dis-cretion
of the court, not less than five nor more than fifty dollars, or less than ten nor
more than thirtj' daj's. * * * In any city or incorporated town having a regularly
appointed medical health officer who is a member of the County Board of Health, the
duties assigned in this section to the Count}' Superintendent of Health shall be per-formed
by the said medical health officer for the people of his city or town. * * * "
1. Every person sick of either of the diseases mentioned in the above
•extract from section nine should be immediately isolated, with his nurses,
in a separate room, if there is one. and nothing: should be taken out of
FIFTH BIENNIAL REPORT. 41
such room at any time without having been previousl}' disinfected in the
manner described under the head of disinfection. The mildness of the
attack must not be laermitted to beget laxity in carrying out these
hist ructions.
2. When any of the diseases mentioned above occurs in a house con-taining
only one room, the house and all persons residing therein should
be quarantined. The same rule should apply to the entire house, even
if of sufticient size to permit the isolation of the sick person and his
nurses in a separate room, in cases of small-pox, cholera, yellow fever,
and typhus fever; but in cases of scarlet fever and diphtheria the quar-antine
need extend only to the room occupied by the patient and his
luirses and to the occu])ants thereof Whenever possible persons sick of
small-pox, cholera, typhus fever or yellow fever should be immediately
removed to quarters specially provided for the detention and treatment
of such cases. Particular care should be taken to quarantine for a time
sufficiently long to insure safety to others all persons who were exposed
to infection before the removal of the patient.
3; When a house or room is in quarantine no one whatever except the
.attending physician and the clergyman of the family slsould be admit-ted.
The person doing the outside service for a quarantined family
should take orders verbally from a distance, and should lay down at the
entrance of the house or room any aiticles he may bring there. Xo pet
•dog or cat should be allowed in the room.
4. When either of the diseases mentioned has declared itself in a
house no work for trade purposes or for private families should be taken
in by any one inhabiting the same, and all such work as may have been
taken in before the outbreak of the disease should be disinfected before
being sent home.
5. !Xo person recovering from either of these diseases, and no person
who has nursed such a patient, should quit the house before receiving a
certificate from the County Superintendent of Health, municipal medi-cal
health officer, or attending physician, that the precautions required
under the head of disinfection have been taken. Children must have
certificate before re-entering school. See section 13 of the law.
6. No person residing in a quarantined house should go beyond the
lot (or farm, provided there be no other })ersons living thereon) or put
himself in direct communication with any one from outside.
7. When a house is quarantined any person residing therein, other
than the patient, who wishes to leave for tlie purpose of changing his
residence, may do so with the written permission of the County Super-intendent
of Health or municipal medical health officer, provided he
takes all the precautions required under disinfection.
8. The body of every person who has died of either of the diseases
mentioned should be disinfected in the manner described below. It
42 XOKTH CAROLINA BOAKD OF HEALTH.
should be kept isolated up to the moment of the funeral in the room
occupied by such person during his illness. The funeral should take
place as soon as possible, and in all cases be private, attended only by
those absolutely necessary to the proper performance of the burial,
unless the body having been disinfected be in a metal coffin hermetically
sealed. Children should under no circumstances be present.
9. When there is a case of either of the diseases mentioned in a house
a placard stating the name of the disease, to be furnished by the County
Superintendent of Health, shall be posted on the front door of said
house. This placard must not be removed in any case until the jjremises
have been properly disinfected, and then only by the County Superin-tendent
of Health or municipal medical health officer in per.son, or by
exjiress permission of the same.
DISINFECTIOX.
I. DURING THE CONTINUANCE OF THE DI.SE.\SE.
{a). All the sunlight possible and as much fresh air as the nature of
the disease and the state of the weather will permit should be admitted
to the sick-room.
(/)). The expectorations and evacuations of the patient should be received
in vessels in which there is a considerable quantity of bichloride of
mercury, solution Xo. 2, or milk of lime, or an equal quantity of either
of them should be added thereto and the mixture allowed to stand at
least a half hour before throwing into the water-closet, if the house be
connected with a system of sewers, or, otherwise, should be buried at a
distance of not less than 100 feet from any well or spring.
(c). Soiled body and bed-clothing, handkerchiefs, rags, etc., should, as soon
as discarded, be immediately burned or immersed in a vessel of suffi-cient
size, containing enough of the zinc or chloride of lime solution
to completely cover them, and kept there until they can be thoroughly
boiled for not less than a half hour in plain water, or better the zinc
solution, and then washed and dried in the sun.
(fZ). The remains of the food served to the patient should be burned
in the room or soaked in one of the disinfecting solutions mentioned
and then buried.
II. AFTER THE RECOVERY, REMOVAL OR DEATH OF THE PATIENT.
(a). Of the articles used and room occupied by the patient. The vessels
should be washed with a disinfecting solution. Burn in a hot fire suffi-ciently
fierce to consume quickly and completely such articles as are not
too valuable. Others that can be boiled without injurv should be boiled
hard for not less than a half hour, then thoroughly washed and dried in
the sun. The remainder—furniture, curtains, woolen clothes, pillows,
beds, mattresses (the contents of mattresses when straw, shucks or other
FIFTH BIENNIAL REPORT. 43
cheap material should be burned and the ticks boiled) and all other
articles which have been exposed to the infection should be hung on
racks, or otherwise looselj^ distributed about the room, so as to permit
free access of the gas to every part, the carpet, if there be one, being
left on the floor, and then disinfected at the same time with the room by
sulphur fumigation. Afterwards they should be taken into the open air
and thoroughly beaten and sunned.
If preferred, in cases where every article in the room can be subjected
to the process to be named, or when the I'oom cannot be made tight
enough to retain the sulphur fumes, every article in the room which can
be should be boiled and the remainder, including the floor and wood-work,
should be well washed with the bichloride solution No. 1. The
walls and ceiling should have the same solution thorouf/JiIy applied to
them or be well whitewashed.
{b). Of the. person of the recovered patient. Wash the body, including
the hair, with the bichloride solution No. 1 and put on clean clothes
that have not been in the sick-room or that have been disinfected as
prescribed in 1 (c).
(e). Of the dead hodij. Wrap the bod}' in a well-sewed sheet thoroughly
saturated with the bichloride solution No. 2 or with the chloride of lime
solution. Put two pounds of chloride of lime in the coffin.
(fO- Qf persons before leacing a house ivhicJi ]ias been, qnarantoied. Wash
at least the uncovered portions of the body—hands, face, beard and hair
—better the entire body—in the bichloride solution No. 1 and put on
clean clothes that have not at any time been exposed to the infection or
have been disinfected in the manner described. The notice of the attend-ing
physician and visiting clergyman is called to the importance of their
observing these precautions and at least washing their hands in the
bichloride solution the last thing before leaving the room.
{e). Of a vehicle used to carry the body, living or dead, affected witJi either
of the diseases enumerated. Remove all cushions, curtains and other acces-sories
and disinfect by boiling or soaking in the bichloride solution No. 1
and wash out the interior with bichloride solution No. 2.
DISINFECTANTS.
1. Bichloride of mercury, solutinn No. 1. Bichloride of mercurj' 1
drachm, water 1 gallon.
2. Bicldoride of mercury, solution Xo. 2. Two drachms to the gallon.
Owing to its poisonous character a solution of bichloride should be col-ored
w itii bluing to prevent mistakes. It should be kept in earthen or
wooden vessels, as it corrodes metals.
3. Ztuc solution. Sulphate of zinc (white vitriol) 4 ounces, salt 2 ounces,
water 1 gallon.
4. Chloride of lime solution. Fresh chloride of lime 6 ounces, water 1
gallon.
44 NORTH CAROLINA BOARD OF HEALTH.
5. Milk of I'nne {irhneirash). Pour on 1 quart of quick-lime, broken into-small
ijieces, 1 quart of water. As soon as reduced to powder add 3-
quarts of water. Store in well-closed vessel. ^lake fresh supply every
few days, as it does not keep well. Can be kept much longer by pouring:
one-half cup of kerosene on top to exclude air.
(j. Sulphur finnlgation. The room must be vacated. Close as tightly
as possible every opening, fire-place by stutting tiiroat of chimney witli.
old bags or plenty of straw; cracks around doors and windows by calk-ing
with tow or cotton, etc. Place small lumps or powdered sulphur, in
the proportion of 3 pounds for every 1,000 cubic feet of air space to be-disinfected,
in an iron pot or pan free from cracks. Set the vessel, if it
has no legs, on bricks in the bottom of a tub containing 2 or 3 inches of
hot water (to put out fire in case burning sulphur should leak out or
overflow); light with red-hot coals or by pouring on a tablespoonful of
alcohol and applying a match. Be careful not to inhale the fumes. Close
the door of exit as tight as possible. Keep the room closed for twelve
hours, excei^t in cases where family has no other room to sleep, then,
six hours. Then open all doors and windows and air thoroughly.
NOTE.
It i.« practically established that if the instructions given in this circu-lar
ai'e faithfully carried out these justly dreaded diseases will not spreads
Such being the fact the responsibility of those whose duty it is to carry
them out is great.
A positive })romise from the attending physician to the County Super-intendent
of Health, or to the municipal medical health officer, to see
that the instructions are faithfully carried out would relieve the latter of
responsibility.
The Count}' Superintendent of Health or the municipal medical health
officer should not fail to promptly furnish to both the attending physi-cian
and the liouseholder in whose family either of the diseases men-tioned
in section 9 occurs a copy of these instructions.
Any further information desired will be cheerfully furnished.
RICH'D H. LEWIS, M. D.,
Secretary.
A copy of these instructions, together with a copy of
the new hiw, was mailed to every registered physician in
ever}^ county in North Carolina except four, from the
Clerks of which no reply has been received to either of mj-two
letters: I shall write them a^ain.* The total number
*The list of physicians has been made complete, and the instructions were promptly
distributed.
FIFTH BIKNNIAL KEPORT. 45-
mailed so far is 1,517. The "instructions" in quantity
will be sent to all County Superintendents and municipal
health officers. With them will be sent the placards
required to be posted on the front door of every house con-taining
a case of either of the diseases mentioned in sec-tion
nine.
Continuing the plan of trying to educate the people in
sanitary matters b}' popular articles in the newspapers, I
sent an article, together with a copy of the Instructions for
Quarantine and Disinfection, to every newspaper in the
State with a request that they publish same.
Just on this line members of the profession can be of
great assistance, provided they approve of the plan and
the articles, by using their influence with the editors of
their local papers to get them to publish them. A public
sentiment favorable to sanitation must be built up if we
expect to make any substantial progress. The Anglo-
Saxon people of this free country cannot be driven to the
performance of what they do not approve. They must be
persuaded of the importance of these restraints upon their
liberties under certain circumstances before they can be
successfully imposed.
But the physicians of the State can be of much greater-service
to the cause of the public health in another way,,
and that is by giving to the law and the sanitary regula-tions
imposed by it their own cordial support. Indeed
the practical application of the law is in the hands of our
medical men. If they give it their cordial support and
urge its importance upon their patients it will be carried
out, but if the}' are indifferent, and make light of and
belittle it it will surely be largely of no effect. In view of
the wholesale danger to life of the spread of contagious
and infectious diseases, which can almost surely be pre-vented
by the strict enforcement of .^anitary regulations,
46 NOIITH CAROLINA BOARD OF HEALTH.
this is no light responsihiUty wliich rests upon us, whether
Y\'o arc willino- to assume it or not.
kSeetion 1!) of tlio law requires all Htatc institutions
before adojiting a system of water supply and sewerage to
consult the State Board of Health. In compliance with
that requirement the President of the Board of Directors
of the proposed School for the Deaf and Dumb at Morgan-ton
addressed the following letter to the President of the
Board of Health :
BiLTMORE, N. C, March 31, 1893.
/);. Herirn T. Brosperity of your town. The ordi-dance
may strike you as being rather voluminous, but a careful consid-eration
of the same will, I think, show the reasonableness and impor-tance
of each section. Still, if deemed necessary, it can be modified to
suit the particular conditions of your town, though I would be glad to
have it adopted as it stands in order to secure a uniform system in every
town in the State.
In cities and towns where people are more or less crowded together,
and the danger of contamination of air and drinking water and of the
spread of communicable diseases from person to person is in consequence
greatly increased, the practical application of sanitary laws is especially
important. The collection of vital statistics, particularly those relating
to the cause of death, should be carefully looked to in order to ascertain
those most prevalent, with a view to taking special precautions against
them in the future. It is also of great importance from a material point
of view. One of the liist inquiries made by intending immigrants is in
regard to the healthfulness of tiieir contemplated destination, and that
information would be sought for at this office. To give an opinion I
must be assured of their coiiiplcteuess and accuracy. Those two essentials
cannot be obtained unless the method recommended is faithfully carried
out, viz., the positive refusal to allow the body of any one dying in the
town to be buried or removed without a permit from a designated
official, based upon a properly tilled out and signed death certificate
giving the cause of death; or some other method e(}ually as reliable.
The healthfuhiess of our State is one of its greatest attractions, and the
only way to demonstrate it to strangers in these days of scientific
accuracy is by means of reliable vital statistics. In our present stage of
sanitary development these statistics can only be obtained from our
cities and towns, and I trust y(ju will help your own immediate home
and, at the same time, aid me in show'ing to the world our advantages
in this most important item of health.
Any further assistance in my power would be most gladly rendered l.-y.
Yours very respectfully,
RIGHT) H. LEWIS, SI. I).,
Sccrettiri/.
'~>0 NORTH CAROIJXA P.OARD OF HEALTH.
ORDINANCE OF THE OF
FOR THE BETTER PRESERVATION OF THE PUBLIC HEALTH
AND TO PREVENT THE SPREAD OF C0M:\IUNICABLE DIS-EASES.
In virtue of the powers conferred by section 25, chapter 214, Laws of
1893 of the State of Nortii Carolina, be it ordained by the-of
thet ----of --,anditis hereby ordered by the
authority of the same
—
Section' 1. That the Mayori shall constitute a Local
Board of Health for thet of , whose duty
it shall be to faithfully execute all Laws of the State (chapter 214, Laws
of 1893—An Act Relating to the Board of Health) and all ordinances
relating to the public health of thef of The
Board of Health shall have power to make all necessary rules and regu-lations
for the promotion and preservation of the public health and the
collection and registration of vital statistics within thet
of --.subject to the ratification of the* A
majority of the members shall constitute a quorum.
Sec. 2. The ]\Iayor shall be ex officio President of the Board of Health.
Heshall convene the Board in regular session on the first*]^
in each month from April to Octol^er inclusive, and quarterly thereafter,
and shall have power to call the said Board together in extra session
whenever, in his judgment or in that of the health officer, the public
health demands it.
Sec. 3. The medical member| of the Board shall be e.v officio the health
officer of thet , and shall be the executive officer of the
*Insert City Couucil, Board of .-Vldermen or Board of Town Conunissiouers, as the
•case may be.
tCity or Towu.
'^Foi- small lo7c!is insert '"the Town Clerk and the County Superintendent of Health "
{if that official is a resident of the town and acceptable to the town authorities), otherw^ise
insert "the Town Clerk and a resident registered physician to be elected bj- the Board
of Towu Comiuissioners."
F'or larger tozvns insert " the Towu Clerk and three resident registered physicians to
be elected by the Board of Town Coniinissioners.'' If preferred insert "the Town Clerk
and three other persons, one of whom shall be a resident registered physician to be
elected, etc."
For cities insert " Chief of Police, City ,\ttornej-. Chairman of the Sewer Committee.
Chairman of the Water Committee, Chairman of the Street Committee and County
Superintendent of Health" (if he be a resident of the city), otherwise " a resident regis-tered
physician to be elected by the Board of Aldermeu." Perhaps it might be better
to insert after City Attorney "the County Superintendent of Health and three other
resident registered physicians to be elected by the Board of .\ldermen."
•"Insert day of week.
5\Vhere there is more than one medical member of the Board substitute " The medi-cal
member of the Board receiving the highest number of votes shall be the health
officer."
FIFTH niKXXIAr. i;Er(*RT. ol
Board. He shall perform for the* the duties^ of the County
Superintendent of Health as laid down in Chapter 214, l^awsof 189o, and
such other duties as may be imposed by the Board, including the collec-tion
of vital statistics, which he shall use every effort to make as full and
accurate as possible, especially such as relate to the cause of death. He
shall notify the Secretary of the State Board of Health of his election
and shall make such reports and answer such inquiries concerning the
sanitary condition of thef , diseases prevalent, vital statistics,
etc., as may be required by the State Board of Health. He shall hold
his office for years, and until his successor is appointed
and has qualified.
Sec. 4. The* Clerk shall be ex officio Secretary of the Board.
He shall keep a full and accurate record of all business done at its meet-ings.
He shall cause to be published in the newspapers of the*
and by printed or written notices, to be posted inf , all orders,
rules and regulations of the Board, which pablication shall be deemed
legal notice of the same to all persons. He shall file and keep for refer-ence
all reports, complaints, orders or other papers relating to the busi-ness
of the Board. He shall also keep, in a book provided for the pur-pose,
a full and complete record in detail of all vital statistics.
Sec. 5. The Board of Health may, with the approval and consent of
the Board of J electa speciaHj , or use one
of the regular force, who shall be known as the Sanitary Inspector. He
shall inspect at least once in every month, from April to October inclu-sive,
the premises of every householder in the "^ He shall
make a note of and report in writing to the health officer any violations
of the orders, rules and regulations promulgated by the Board, and shall
serve such legal notices as the Board may direct. His term of office and
compensation shall be fixed by the Board ofi
Sec. 6. The Board of Health, through its health officer, shall make a
report annually in ]March, for the preceding twelve months ending with
the last day of February, to tiie Board of j
Sec. 7. Whatever is dangerous to human life or health, whatever ren-ders
the air or food or water or other drink unwholesome, and whatever
building, erection, or part or cellar thereof, is overcrowded or not pro-vided
with adequate means of ingress and egress, or is not sufficiently
supported, ventilated, drained, cleaned or lighted, are declared to be
nuisances, and to be illegal; and every person having aided in creating
or contributing to the same, or who may support, continue or retain any
of them, shall be deemed guilty of a violation of this ordinance, and
also be liable for the expense of the abatement and i-emed\' therefor.
*City or Town, flnsert number and location of public places.
|Town Commissioners or Aldermen. IConstable or policeman.
52 NUUTH CAROLINA Bt)AKL) OF HEALTH.
Skc. 8. No house-refuse, oft'al, garbage, dead animals, decaying vegeta-ble
matter or organic waste substance of any kind shall l)e thrown on
any street, road, ditch, gutter or public place within the limits of this
. , and no putrid or decaying animal or vegetable matter shall
beTkept in any house, cellar or adjoining out-]»uilding or grounds for
more than twenty-four hours.
Sec. it. No person or persons without the consent of the Board of
Health"" shall build or use any slaughter-house within the limits of this
, and the keeping and slaughtering of all cattle, sheep and
swine and the preparation and keeping of all meat, tish, birds, or other
animal food, shall be in the manner best adapted to secure and continue
their healthfulness as food; and the keeping of the premises shall be
with such care and cleanliness as not to endanger the public health. No
meat, fish, birds, fowls, fruit, vegetables, milk, and nothing for human
food not being then healthy, fresh, sound, wholesome, tit and safe for
such use, nor any animal or'fish that died by disease or accident, and
no carcass of any calf, pig or lamb which at the time of its death was
less than four weeks old, and no meat therefrom, shall be brought within
the limits of this , or offered or held for sale as food any-where
in said
Sec. 10. No person or company shall erect or maintain within the
limits of this— any manufactory or place of business danger-ous
to life or detrimental to health, or where unwholesome, ofiensive or
deleterioiis odors, gas, smoke, deposit or exhalations are generated, such
as tanneries, refineries, manufactories of starch, glue, leather, chemicals,
fertilizers, gas, etc., without the pernjit of the Board of Health,* and all
such establishments shall be kept clean and wholesome so as not to be
offensive or prejudicial to public health.
Sec. 11. The keeper or keepers of a livery or other stable shall keep
liis or their stable-j-ard clean, and shall not permit, between the first day
of April and the first day of Novembei", more than loads of
manure to accumulate in or near the same at any one time except by
express permission of the Board of Health.*
Sec 12. No pig-pen shall be built or maintained within the limits of
this without a permit from the Board of Health,* or
within one hundred feet of any well or spring of water used for drinking
purposes, or within thirty feet of any street or of any inhabited house,
or unless constructed in the following manner, viz., so that the floor of
the same shall be not less than two feet from the ground in order that
the filth accumulating under the same may be easily removed; and such
filth accumulating in, about and under the same shall he removed at
*Where there is no Board of Health organized snbstitute " Board of Town Commis-sioners
" or " Board of Aldermen.''
FIFTH i'.TKXXIAL REPORT. 53
least once a Aveek, and oftener if so ordered, and on the fiulure of any
owner or occupier of such premise;^ i^o to do, then the same sliall be
done by the
Sec. lo. Xo privy-vault, cess-pool or reservoir, into which a privy,
water-closet, cess-pool or stable or sink is drained, shall be consti-ucted,
dug or permitted to remain within the corporate lin)its of this
Earth privies and earth closets, witli no vault, pit or depression below
the surface of the ground, are allowed, but sufficient dry earth or ashes
must Vje used daily to absorb all the fluid part of the deposit, and the
contents must be completely removed at least once every month. •-
Sec. 14. The following diseases are declared to be communicable and
dangerous to the public health, viz.: small-pox (variola, varioloid),
cholera (Asiatic or epidemic), scarlet fever, (scarlatina, scarlet rash),
measles, diphtheria (diplitheritic croup, diphtheritic sore throat), typhoid
fever, typhus fever, yellow fever, spotted fever (cerebro-spinal meningitis),
epidemic dysentery, hydrophobia (rabies) and glanders (farcy), and shall
])e understood to be included in th.e following regulations, unless certain
of them only are specified.
Sec. 15. Whenever any householder knows that any person within
his family or household has a communicable disease, dangerous to the
public health, he shall, within twenty-four hours, report the same
to the health otficer,t giving the street and numl)er or location of the
house.
Sec. 1(i. Whenever any jihysician finds that any person whom he is
called upon to visit has a communicable disease, dangerous to the public
health, he shall, within twenty-four hours, report the same to the health
officer,t giving the street and number or location of the house, on the
receipt of which report the health officer shall immediately notify the
school committee of the public school, the superintendent of the
graded school and the principals of private schools within the limits of
this , at the same time calling their attention to Section
13, Chapter 214, Laws of 1893.
Sec. 17. No person shall, within the limits of this , unless
by permit of the health oflEicer,j carry or remove from one building to
another any patient atFected with any communicable disease dangerous
to the public health. Nor shall any person, by any exposure of any
individual so afiected, or of the bodv of such individual, or of any
*To towns and cities having- already or about to introduce a system of sewerage sug-gestions
as to the proper ordinances will be gladly furnished by the Secretary of the
State Board of Health.
fWhere there is no medical health officer insert "County Superintendent of Health."
as required by chapter 214, Laws of 1S93.
tWhere there is no Board of Health insert "County Superintendent of Health."
54 NOKTH CAROLINA BOARD OF HEALTH.
article capable of conveying contagion or infection, or by any negligent
act connected with the care or custody thereof, or by a needless expo-sure
of himself or herself, cause or contribute to the spread of disease
from any such individual or dead body.
vSec. 18. There shall not be a public or church funeral of any person
who has died of Asiatic cholera, small-pox, typhus fever, diphtheria,
yellow fever, scarlet fever or measles, within the limits of this
and the family of the deceased shall in all such cases limit the attend-ance
to as few as possible, and take all precautions possible to prevent
the exposure of other persons to contagion or infection; and the person
authorizing the public notice of death of such person shall have the
name of the disease which caused the death appear in such public
notice.
Sec. 19. Xo person shall let or hii'e any house, or room in a house, in
which a communicable disease, dangerous to the public health, has re-cently
existed, until the room or house and premises therewith con-nected
have been disinfected to the satisfaction of the Board of Health,'^
in accordance with the "Instructions for Quarantine and Disinfection"
furnished by the Secretary of the State Board of Health; and for the
purposes of this section the keeper of a hotel, inn, or other house for
the reception of lodgers, shall be deemed to let or hire part of a house
to any person admitted as a guest into such hotel, inn or house.
Sec 20. Members of any household in which small-pox, diphtheria,
scarlet fever or measles exists shall abstain from attending places of pub-lic
amusement, worship or education, and fiom visiting other private
houses except on express permission of the health officer.*
Sec. 21. The clothing, bed-clothing and bedding of persons who have
been sick with any communicable disease, dangerous to the public health,
and the articles which they have used and the rooms which they have
occupied during such sickness shall be disinfected under the direction
of the Board of Health* in accordance with the "Instructions for Quar-antine
and Disinfection" furnished by the Secretary of tlie State Board
of Health.
Sec. 22. Upon the appearance of a case of small-pox inf
county it shall be the duty of every adult and every parent, guardian or
master of every minor residing within the limits of thisi ,
who has not had small-pox or been vaccinated so as to have taken cow-pox
regularly, to be, if an adult, vaccinated, or in the case of a minor,
to cause such minor to be vaccinated within two weeks after the appear-
*Where there is no Board of Health insert "County Superintendent of Health."
tlnsert name of county in which town or city is situated, or if preferred substitute
"within a radius of miles."
JCity or town.
FIFTH BIENNIAL REPORT. 55
ance of such case of small-pox unless unable to do so \)y reason of pov-erty;
and it shall be lawful for any registered physician residing in this*
, on application of such resident adult, or parent, mas-ter
or guardian of such resident minor, as is unable by reason of poverty
to pay the vaccination fee, to vaccinate said adult or said minor and
present his bill therefor, properly authenticated, for an amount not
exceeding the fee iisually charged for such services, and to recover the
same of and from the corporation, f
Sec. 23. Every undertaker or other person who may have charge of
the funeral of any dead person shall procure a properly filled out cer-tificate
of the death and its probable cause, in accordance with the form
prescribed by the State Board of Health (no other to be valid), and shall
present the same to the designated otlicer or member of the local Board
of Health and obtain a burial or transit permit thereupon at least twenty-four
hours before the time appointed for such funeral or removal; and
neither lie nor an}- other person shall remove any dead body until such
burial or transit permit shall have been procured.
Sec. 24. Every person undertaking preparations for the burial of a body
dead from communicable disease as hereinbefore enumerated shall adopt
such precautions as are set forth in the "Instructions for Quarantine and
Disinfection," furnished by the State Board of Health, to prevent the
spread of such disease.
Sec. 25. Every physician or midwife attending or present at the l)irih
of any human being within the shall, wdthin twenty-four hours
thereafter, certify the same to the health officerj upon blanks prescribed
by the State Board of Health to be furnished by said health officer. In
case there be no attending physician or midwife, then the next of kin or
other person present at such birth shall, within twenty-four hours there-after,
report the same to the health officer, who shall then have the
proper blank filled out.
Sec. 26. All physicians, midwives and undertakers practicing or doing
business in this shall register their names and addresses with
the Secretary of the Board of HealthlT within thirty daj-s after the pro-mulgation
of this ordinance; and hereafter within ten days after begin-ning
practice or business.
Sec. 27. Such pertinent portions of chapter 214, Laws of 189o, as are
not included in the above sections are hereby adopted as a part of this
ordinance.
Sec. 28. Every person violating any section of this ordinance shall be
liable for every such offense, upon conviction before the mayor or other
*City or town.
flf preferred the vaccination of paupers might be required of the health officer,
where there is one. the town furni.shin.s: the virus, or the fee might be fixed in advance
by agreement with the physicians. The vaccination of tlie people is of tlie highest
importance and everj' effort should be made to accomplish it. The amount of raw-material
ready to be worked up by small-pox in this State is simply appalling.
JWhere there is no health officer substitute " Citv or Town Clerk.''
IJWhere there is no Board of Health substitute "City or Town Clerk."
4
56 NORTH CAROLINA BOARD OF HEALTH.
justice of the peace, to a fine of not less than S."5 nor more than $25, or
imprisonment for not more than ten days, at the discretion of the con-victing
justice, besides costs, which he may inflict in addition if he see fit.
BIRTH CERTIFICATE.
N. C, ISO-Date
of Birth
Name of Child, if named
Name of Father
Name of Mother
Residence, No Street Ward
Color Sex ^
Condition of Child
Attendin'g» Physician or Midwife
CERTIFICATE OF DEATH AND APPLICATION FOR BURIAL
OR TRANSIT PERMIT.
To the* of N. C:
Date of Death
Full Name of Deceased!
Sex, Male or Female
Age Years Months Days.
Color
Married, Single, Widow' or Widower
Occupation
Birthplace
Place of Death, No. , Street, Ward.
Cause of Death
Duration of Last Sickness
Place of Burial -_ ^
Date of Burial I M. D.,
f Undertaker f Medical Attendant.
\ Place of Business j %
Personally appeared before me on this the day of 189--
and made oath that the above statement
in regard to the death of is true.
,J. P.
*This certificate must be returned to the official selected for the purpose—Town Clerk,
Chief of Police or some other— for Burial Permit.
tif still-born, give names of parents on this line.
jlu case there was no medical attendant, this certificate may be signed by the Health
Officer, after careful inquirj' as to the facts required to be noted. Or it ma3' be signed
on oath before a Justice of the Peace by the householder in whose house the death
occurred, or by the next friend of the deceased who was present. Where there was an
attending physician no other signature than his should be accepted.
Note.—The apparent amount of " red tape" in this certificate in the matter of requir-ing
the householder or next friend to make oath before a Justice of the Peace is ren-dered
necessary by the fact that death certificates are often used in the courts as evi-dence,
and the disposition of large sums of money may depend upon their accuracy and
reliability.
L'lFTH BIENNIAL REPORT. 57
nj
so oO
o
•-^
W
p
^ G
58 NORTH CAROLINA BOARD OF HEALTH.
FORM FOR SAXITARY INSPECTION OF CITIES AND TOWNS.
1. Inspection-books are furnished as per Form No. 1.
2. The Inspector is presumed to have received intelligent drilling from
the Health Officer in the many features of unsanitariness which will be
met with, and is moreover, presumed to be a person of good judgment
and discretion, and to have a high standard of sanitary methods, with
his heart in the work.
3. The inspection districts having been designated by the Board, the
Inspector begins work at a set point and makes an entire inspection of
the district house by house, block by block, noting down the conditions
in Inspection-book as provided under manner of Form No. 2.
4. Should any bad features exist the Inspector is to point out to the
householder where the remedy can be applied and the necessity for it,
and to leave upon the premises the notice of Form No. ;]. Should the
existing conditions be not really bad, but clearly not good, the Inspector
is required to inform the householder where the defect lies, and to urge
upon liim the benefits resulting from thorough cleanliness.
5. After each inspection district has been gone over Inspector should
make a report to the Health Officer or Mayor of total inspections and
their results upon Form No. 4: this to be kept on file by the Secretary
of Board for future comparisons.
6. A space of nine lines should be given to each lot in order that the
record of the whole number of inspections made during the year
(monthly from April to October, inclusive, and quarterly thereafter)
may be arranged for easy comparison. The Inspector should not only
call attention to violations of the sanitary rules and regulations and
note bad conditions, but he should make it a point to encourage those
who are evidently trying to do their sanitary duty.
7. At stated intervals a notice should be given through the public
press of what the comparative results show, thereby enlisting an interest
in the work from those who might not be reached bv other means.
Although modified by myself in some respects, the credit for these forms is due to
Mr. Alfred V. Wood. Secretary of the Board of Health of Brunswick, Ga., a brother of
our late deepU' lamented Secretarj-, and a sanitary expert.
FIFTH BIENNIAL REPORT. 59
Form No. i.
SAMPLE PAGE OF INSPECTION BOOK.
1893-'94.
April
May
June
July
Aug.
Sept.
Oct.
Jan.
April
May
June
124 Wolf Street,
(I
1 T. PI. Jones,
And so on down.
1
60 NORTH CAROLINA BOARD OF HEALTH.
To be sent on the first day of each mouth for the mouth preceding to the Health
Officer or Alayor.
Form No. 4.
SAXITARY INSPECTION DISTRICT No
Month of 189-
FIFTH BIENNIAL REPORT. 61
known to carry contagion. He invited members of the
Society to visit the Station after its completion and see it in
operation.
Dr. Reagan deprecated the lack of interest on the part of
members in the Conjoint Session, and thought this lethargy
must be overcome before we can expect to excite the interest
of the legislators and the laity.
Dr. H. W. Lewis said it would take the stimulus of an
epidemic to create an interest in sanitary matters among the
physicians of his county. In making his reports as Superin-tendent
of Health he had to depend almost entirely upon
his own practice in enumerating the prevailing diseases.
He thought the law, while probably as good as could be
obtained, was defective in not making provision for the
remuneration of Superintendents for their extra and especial
services in case of epidemics. He understood the law to
only give the Superintendent the right to charge for his
visits to the poor-house and jail. (The Secretary explained
that it gave him the right to demand the fees usual in his
count}' for any services he might render). He regretted
there had been no legislation in regard to vaccination. His
county was raising a large crop for the Reaper should an
epidemic of sraall-pox appear.
The Secretary stated that in regard to vaccination tlie
Conference were in accord as to the desirability of com-pulsory
vaccination, but that such a clause in the bill would
have jeopardized the whole bill. People cannot be driven
in these matters. In this connection he referred to some
remarks made by Dr. Lewis at the last meeting, when he
stated that he had appointed a day on which to vaccinate
the pupils at a county school, and when he arrived there
he found that all the school had taken flight.
The Secretary announced that the terms of office of him-self
and Dr. Bahnson expired with this meeting, and that
62 NORTH CAROLINA BOARD OF HEALTH.
imder the new law these vacancies would be filled by the
Governor's appointment.
There was some discussion as to whether it would be
proper for the Society to recommend candidates for appoint-ment,
but it was the sense of the meeting that it should be
left for the Governor to ask for such recommendation should
he desire it.
The Secretary called the attention of Superintendents of
Health to the fact that it is now made obligatory on him to
notify the County^ Commissioners of the failure on the part
of the Superintendents to make their reports. He also
urged upon physicians to attend the meetings of the Board
of Health for the election of Superintendents that proper
men may be selected for these positions.
On motion the Conjoint Session adjourned.
RICH'D H. LEWIS, M. D.,
Secretary.
CONJOINT SESSION AT GREENSBORO, MAY 15, 1894.
At 12 M. the Board met in conjoint session with the
State Medical Society, President Bahnson in the chair.
Passed Assistant Surgeon Jos. J. Kinvoun, of the United
States Marine Hospital Service, having accepted an invita-tion
of the President of the Board to attend the meeting, was
upon motion invited to a seat upon the floor and to partici-pate
in the discussions. He acknowdedged the courtesy in
an appropriate manner.
The Secretary then read his annual repoi't as follows:
FIFTH lUKXXIAL REPORT. 03
ANNUAL REPORT OF THE SECRETARY OF THE
NORTH CAROLINA BOARD OF HEALTH.
By Richard H. Lewis, M. D., Raleigh, N. C.
AVhen your Secretary made his last annual report the
sanitary sky to the eastward was overcast with the dark
and lurid clouds of cholera. There was in the minds of
people at large to some extent, hut more especially of those
whose duty it was to stand as sentries upon the watch-towers,
a feeling of apprehension lest these threatening
clouds should reach our shores and deluge us with the
dreaded pestilence.
Later yellow fever appeared at Brunswick, Ga., almost
at our doors, and our health officers ou our seaboard,
particularly at our port of Wilmington, had their anxieties
greatly increased. Still later small-pox began to spread
over the country and is not 3'et, we regret to admit,
stamped out.
Notwithstanding these valid grounds for uneasiness our
fears have not been realized. "We have to felicitate our-selves
and the people of our State and generally of our
whole country upon their escape. And in doing so we
should make our acknowledgments to the United States
Marine Hospital Service for its excellent management in
keeping cholera (except one case at Jerse}'' City) out of our
country and in practically bottling up the yellow fever at
and near Brunswick.
In making this report your Secretary does not